Organization
ORMOND RADIOLOGY PARTNERSHIP, L.L.C.
Active
Other names
Suncoast MRI of Ormond
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JT TENER (HUMAN RESOURCES/CREDENTIALING)
(386) 673-8070
Entity
Organization
Contact information
Practice address
500 MEMORIAL CIR, SUITE E-2, ORMOND BEACH, FL 32174-5054
(386) 673-7056
(386) 673-7815
Mailing address
500 MEMORIAL CIR, SUITE B, ORMOND BEACH, FL 32174-5054
(386) 673-8040
(386) 267-0693
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CD5225
RR MEDICARE GROUP #
FL
01
—
V3002
BCBS GROUP NUMBER
FL
Enumeration date
04/21/2006
Last updated
12/12/2007
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