Organization
GAINESVILLE RADIOLOGY GROUP WEST, LLC
Active
Organization
GAINESVILLE RADIOLOGY GROUP WEST, LLC
Active
Other names
Putnam Radiology Group
Organization subpart
No
Provider details
NPI number
Authorized official
TONY ARVESU (MANAGING MEMBER)
(352) 332-2040
Entity
Organization
Contact information
Practice address
4960 W NEWBERRY RD, STE 280, GAINESVILLE, FL 32607-2201
(352) 371-3336
(352) 371-3372
Mailing address
4960 W NEWBERRY RD, STE 280, GAINESVILLE, FL 32607-2201
(352) 371-3336
(352) 371-3372
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
256176
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
V2766
BCBS IDTF NUMBER
FL
01
—
V3013
BCBS IDTF NUMBER EAST OFC
FL
Enumeration date
05/24/2005
Last updated
08/22/2020
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