Provider Demographics
NPI:1023232907
Name:AMERICAN RADIOLOGY SERVICES
Entity type:Organization
Organization Name:AMERICAN RADIOLOGY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:MARZANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-430-4674
Mailing Address - Street 1:2338 IMMOKALEE RD
Mailing Address - Street 2:STE116
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-1445
Mailing Address - Country:US
Mailing Address - Phone:239-430-4674
Mailing Address - Fax:239-659-6530
Practice Address - Street 1:9500 BONITA BEACH RD SE
Practice Address - Street 2:STE 211
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34135-4698
Practice Address - Country:US
Practice Address - Phone:239-430-4674
Practice Address - Fax:239-659-6530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME81325261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLV2729OtherBCBS PROVIDER NUMBER
FLV2538OtherBCBS PROVIDER NUMBER
FLC42814Medicare UPIN