# RADIOLOGY EXPRESS POINCIANA LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972039857
- **Authorized official:** DR. DALE CHRISTOPHER NEWTON ME50820 (MANAGER)
- **Authorized official phone:** (407) 915-3564

## Contact information

- **Practice address:** 1016 CYPRESS PKWY, KISSIMMEE, FL 34759-3328
- **Practice address phone:** (407) 915-3564
- **Practice address fax:** (407) 350-5967
- **Mailing address:** 1016 CYPRESS PKWY, KISSIMMEE, FL 34759-3328
- **Mailing address phone:** (407) 915-3564
- **Mailing address fax:** (407) 350-5967

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302F00000X | Exclusive Provider Organization | ME50820 | FL | Yes |

## Other

- **Enumeration date:** 05/11/2017
- **Last updated:** 05/11/2017