Organization
OSCEOLA RADIOLOGY ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN C HOLMAN (SR. DIRECTORE, RCM)
(866) 674-7933
Entity
Organization
Contact information
Practice address
700 W OAK ST, KISSIMMEE, FL 34741-4924
(407) 846-2266
(407) 518-3158
Mailing address
PO BOX 160923, ALTAMONTE SPRINGS, FL 32716-0923
(866) 674-7933
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
266896300
—
FL
01
—
34765
BC BS OF FLORIDA
FL
01
—
DA1725
RAILROAD MEDICARE
—
Enumeration date
11/19/2005
Last updated
01/14/2022
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