Organization
VERO RADIOLOGY ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY L. LONGVILLE (OFFICER - CAO AND CONTROLLER)
(216) 636-7416
Entity
Organization
Contact information
Practice address
3725 11TH CIRCLE, VERO BEACH, FL 32960-4804
(772) 562-0163
(772) 567-5631
Mailing address
PO BOX 830674, BIRMINGHAM, AL 35283-0674
(855) 666-9508
(772) 621-3184
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014512200
—
FL
01
—
CB7533
RAILROAD MEDICARE
FL
01
—
V2567
BLUE CROSS AND BLUE SHIELD
FL
Enumeration date
08/09/2005
Last updated
01/12/2024
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