Provider Demographics
NPI:1851484141
Name:RADIOLOGY CONSULTANTS OF PALM BEACH
Entity Type:Organization
Organization Name:RADIOLOGY CONSULTANTS OF PALM BEACH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VLADIMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:GRNJA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-929-3400
Mailing Address - Street 1:2450 HOLLYWOOD BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33020-6624
Mailing Address - Country:US
Mailing Address - Phone:954-929-3400
Mailing Address - Fax:954-929-2001
Practice Address - Street 1:6766 FOREST HILL BLVD
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33413-3321
Practice Address - Country:US
Practice Address - Phone:561-966-2270
Practice Address - Fax:561-966-9837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAME20137261QR0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0206XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mammography
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE6175Medicare ID - Type Unspecified