Organization
FLORIDA RADIOLOGY MANAGEMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES MAY (CHIEF EXECUTIVE OFFICER)
(407) 767-0433
Entity
Organization
Contact information
Practice address
7050 GALL BLVD, ZEPHYRHILLS, FL 33541-1347
(813) 783-6114
Mailing address
PO BOX 150340, ALTAMONTE SPRINGS, FL 32715-0340
(407) 767-0433
(407) 767-0608
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
94835
BCBS GROUP PROVIDER #
FL
01
—
DD609
RR MEDICARE - GROUP
FL
Enumeration date
02/06/2006
Last updated
11/27/2007
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