Organization
SRA VENTURES INC
Active
Other names
WESTCOAST RADIOLOGY
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTHONY ABOUD DO (CEO)
(727) 446-6760
Entity
Organization
Contact information
Practice address
1193 BLACKWOOD AVE, UNIT H, OCOEE, FL 34761-4518
(407) 656-6040
(407) 656-4431
Mailing address
501 S LINCOLN AVE, #15, CLEARWATER, FL 33756-5945
(727) 446-6760
(727) 441-2465
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
V3014
BC/BS OCOEE, FL
FL
Enumeration date
08/02/2006
Last updated
07/27/2012
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