Provider Demographics
NPI:1619543485
Name:RADIOLOGY IMAGING SPECIALISTS LLC
Entity Type:Organization
Organization Name:RADIOLOGY IMAGING SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHINTAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DESAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-274-9565
Mailing Address - Street 1:11050 LAKE UNDERHILL RD # 865394
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-5016
Mailing Address - Country:US
Mailing Address - Phone:352-274-9565
Mailing Address - Fax:352-342-9038
Practice Address - Street 1:2100 CREIGHTON RD
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-7218
Practice Address - Country:US
Practice Address - Phone:352-274-9565
Practice Address - Fax:888-978-5541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-02
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty