Provider Demographics
NPI:1457690810
Name:HKG RADIOLOGY LLC
Entity Type:Organization
Organization Name:HKG RADIOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HARMINDAR
Authorized Official - Middle Name:K
Authorized Official - Last Name:GILL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-390-3339
Mailing Address - Street 1:27160 BAY LANDING DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34135-4301
Mailing Address - Country:US
Mailing Address - Phone:239-390-3339
Mailing Address - Fax:239-390-0445
Practice Address - Street 1:27160 BAY LANDING DR
Practice Address - Street 2:SUITE 201
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34135-4301
Practice Address - Country:US
Practice Address - Phone:239-390-3339
Practice Address - Fax:239-390-0445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-05
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME91273261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDKR80C325OtherMEDICARE ID
MD667504200Medicaid
FLAL502XMedicare UPIN
MDKR80C325OtherMEDICARE ID