Organization
EAST CENTRAL FLORIDA OUTPATIENT IMAGING LLC
Active
Parent organization
EAST CENTRAL FLORIDA OUTPATIENT IMAGING LLC
Other names
Radiology Associates Port Orange West
Organization subpart
Yes
Provider details
NPI number
Legal business name
EAST CENTRAL FLORIDA OUTPATIENT IMAGING LLC
Authorized official
AL FALCO (CEO)
(386) 274-7118
Entity
Organization
Contact information
Practice address
5440 S. WILLIAMSON BLVD, SUITE 102, PORT ORANGE, FL 32128
(386) 274-7118
(386) 274-6173
Mailing address
PO BOX 678454, DALLAS, TX 75267-8454
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
06/15/2021
Last updated
08/30/2021
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