Provider Demographics
NPI:1740366764
Name:AFO IMAGING INC
Entity type:Organization
Organization Name:AFO IMAGING INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT & ASSOCIATE GENERAL
Authorized Official - Prefix:MR
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:GAMBILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-414-2037
Mailing Address - Street 1:8300 W SUNRISE BLVD
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33322-5406
Mailing Address - Country:US
Mailing Address - Phone:754-206-6226
Mailing Address - Fax:
Practice Address - Street 1:3104 W WATERS AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-2800
Practice Address - Country:US
Practice Address - Phone:813-463-4444
Practice Address - Fax:813-849-6349
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AFO IMAGING INC DBA ADVANCED DIAGNOSTIC GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-31
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHC863BMedicare UPIN
FLHC863DMedicare UPIN
FLHC863CMedicare UPIN
FLHC863AMedicare UPIN