Provider Demographics
NPI:1700884244
Name:EXCEL MEDICAL IMAGING PL
Entity Type:Organization
Organization Name:EXCEL MEDICAL IMAGING PL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:DEEPAK
Authorized Official - Middle Name:
Authorized Official - Last Name:DAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-841-8212
Mailing Address - Street 1:5626 GULF DR
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34652-4020
Mailing Address - Country:US
Mailing Address - Phone:727-841-8212
Mailing Address - Fax:727-841-9589
Practice Address - Street 1:5626 GULF DR
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-4020
Practice Address - Country:US
Practice Address - Phone:727-841-8212
Practice Address - Fax:727-841-9589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL022584000Medicaid
FL262627600Medicaid
FL38557OtherMEDICARE J07F