Organization
FLORIDA ENDOVASCULAR SPECIALISTS LLC
Active
Parent organization
RADIOLOGY ASSOCIATES PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
RADIOLOGY ASSOCIATES PA
Authorized official
MR. AL FALCO (CEO)
(386) 274-7118
Entity
Organization
Contact information
Practice address
1890 LPGA BLVD, SUITE 140, DAYTONA BEACH, FL 32117-7130
(386) 274-7250
(386) 274-7259
Mailing address
1673 MASON AVE, SUITE 305, DAYTONA BEACH, FL 32117-5515
(386) 274-7118
(386) 274-6173
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000NN
BLUE CROSS BLUE SHIELD OF FLORIDA
FL
Enumeration date
07/22/2010
Last updated
07/22/2010
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