Organization
ADVANCE TECHNOLOGICAL RADIOLOGY, PA
Active
Organization
ADVANCE TECHNOLOGICAL RADIOLOGY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY T ROSA MD (OWNER)
(863) 421-9393
Entity
Organization
Contact information
Practice address
2235 NORTH BOULEVARD WEST, DAVENPORT, FL 33837-8990
(863) 421-9393
(866) 560-1517
Mailing address
P.O. BOX 2159, HAINES CITY, FL 33845-2159
(863) 421-9393
(866) 560-1517
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
255768100
—
FL
Enumeration date
03/05/2007
Last updated
08/10/2021
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