Provider Demographics
NPI:1720700560
Name:RADIOLOGY IMAGING SPECIALISTS LLC
Entity Type:Organization
Organization Name:RADIOLOGY IMAGING SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHINTAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DESAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-274-9565
Mailing Address - Street 1:11050 LAKE UNDERHILL RD # 865394
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-5016
Mailing Address - Country:US
Mailing Address - Phone:352-274-9565
Mailing Address - Fax:888-978-5541
Practice Address - Street 1:10961 BONITA BEACH RD SE
Practice Address - Street 2:
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34135-9017
Practice Address - Country:US
Practice Address - Phone:239-494-4476
Practice Address - Fax:888-978-5541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-19
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty