Provider Demographics
NPI:1922288513
Name:SHARP MEDICAL IMAGING OF FLORIDA, LLC
Entity Type:Organization
Organization Name:SHARP MEDICAL IMAGING OF FLORIDA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:M
Authorized Official - Last Name:JANEIRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-513-2324
Mailing Address - Street 1:5621 STRAND BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-7301
Mailing Address - Country:US
Mailing Address - Phone:239-513-2324
Mailing Address - Fax:
Practice Address - Street 1:5621 STRAND BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-7301
Practice Address - Country:US
Practice Address - Phone:239-513-2324
Practice Address - Fax:239-513-9580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-12
Last Update Date:2007-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QRO2O8X261QR0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile