Provider Demographics
NPI:1639123631
Name:RADIOLOGY DOCTORS, PA
Entity Type:Organization
Organization Name:RADIOLOGY DOCTORS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:S
Authorized Official - Last Name:PARISE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-585-7020
Mailing Address - Street 1:PO BOX 917839
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-7839
Mailing Address - Country:US
Mailing Address - Phone:727-585-7020
Mailing Address - Fax:727-450-1144
Practice Address - Street 1:11375 CORTEZ BLVD
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34613-5409
Practice Address - Country:US
Practice Address - Phone:813-890-8004
Practice Address - Fax:727-518-0762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK2718Medicare ID - Type Unspecified