RADIOLOGY REGIONAL CENTER PA NPI 1174299978

NPI Information

NPI: 1174299978
Provider Name: RADIOLOGY REGIONAL CENTER, PA
Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

Address:
9776 BONITA BEACH RD SE STE 100
BONITA SPRINGS, FL
ZIP 34135
Phone: (239) 444-2200
Get Directions

RADIOLOGY REGIONAL CENTER, PA is a diagnostic radiology radiology in Bonita Springs, FL. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. RADIOLOGY REGIONAL CENTER, PA NPI is 1174299978. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

9776 BONITA BEACH RD SE STE 100
BONITA SPRINGS, FL
ZIP 34135-773
Phone: (239) 444-2200
Fax: (239) 444-2210

The provider's authorized official is Brian A Krivisky .
The authorized official title is Ceo and has the following contact phone number (239) 936-2316.

The enumeration date for this NPI number is 8/20/2021 and was last updated on 8/20/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085R0202X	Radiology	Diagnostic Radiology			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	054636414	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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