INDIAN RIVER RADIOLOGY PA NPI 1689616864

NPI Information

  • NPI: 1689616864
  • Provider Name: INDIAN RIVER RADIOLOGY PA
  • Classification: Radiology - 2085R0202X
  • Specialization: Diagnostic Radiology
  • Entity Type: Organization
  • CLIA Number: 10D2221790
  • Address: 1485 37TH ST
    SUITE 107
    VERO BEACH, FL
    ZIP 32960
  • Phone: (772) 569-9745

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NPI Details

INDIAN RIVER RADIOLOGY PA is a diagnostic radiology radiology in Vero Beach, FL. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. INDIAN RIVER RADIOLOGY PA NPI is 1689616864. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1485 37TH ST
SUITE 107
VERO BEACH, FL
ZIP 32960-500
Phone: (772) 569-9745
Fax: (772) 567-6868

The provider's authorized official is Graham John Cain .
The authorized official title is Business Manager and has the following contact phone number (772) 299-5121.

The CLIA number assigned to this NPI record is 10D2221790 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 6/12/2006 and was last updated on 11/8/2007.

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
12085R0202XRadiologyDiagnostic RadiologyYes

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
139179MEDICARE ID-TYPE UNSPECIFIEDFLORIDA

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: 11/21/2025

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