Provider Demographics
NPI:1982694899
Name:RADIOLOGY ASSOCIATES OF CLEARWATER
Entity Type:Organization
Organization Name:RADIOLOGY ASSOCIATES OF CLEARWATER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:S
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:727-441-3711
Mailing Address - Street 1:PO BOX 223834
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15251-2834
Mailing Address - Country:US
Mailing Address - Phone:727-793-9300
Mailing Address - Fax:727-793-0052
Practice Address - Street 1:300 PINELLAS ST
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3804
Practice Address - Country:US
Practice Address - Phone:727-441-3711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-24
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
FL00212OtherBCBS GROUP NUMBER
FL061291001Medicaid
FL061291000Medicaid
FL061291002Medicaid
FL061291004Medicaid
FL061291006Medicaid
FL061291003Medicaid
FLCC5325OtherRR MEDICARE
FL0007619OtherAETNA GROUP NUMBER
FL061291004Medicaid