Provider Demographics
NPI:1790050847
Name:KEY RADIOLOGY ASSOCIATES LLC
Entity Type:Organization
Organization Name:KEY RADIOLOGY ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGM
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:J
Authorized Official - Last Name:MACCHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-927-0684
Mailing Address - Street 1:5832 TIDEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-3132
Mailing Address - Country:US
Mailing Address - Phone:941-927-0684
Mailing Address - Fax:
Practice Address - Street 1:5832 TIDEWOOD AVE
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-3132
Practice Address - Country:US
Practice Address - Phone:941-927-0684
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-21
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty