Provider Demographics
NPI:1912940792
Name:WEST FLORIDA REGIONAL IMAGING, P.A.
Entity Type:Organization
Organization Name:WEST FLORIDA REGIONAL IMAGING, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:KATZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-381-0275
Mailing Address - Street 1:6449 38TH AVE N
Mailing Address - Street 2:SUITE C4
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710-1655
Mailing Address - Country:US
Mailing Address - Phone:727-381-0275
Mailing Address - Fax:727-345-8025
Practice Address - Street 1:6449 38TH AVE N
Practice Address - Street 2:SUITE C4
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-1655
Practice Address - Country:US
Practice Address - Phone:727-381-0275
Practice Address - Fax:727-345-8025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL40985Medicare ID - Type Unspecified