Organization
ADVANCE TECHNOLOGICAL RADIOLOGY, PA
Active
Parent organization
ADVANCE TECHNOLOGICAL RADIOLOGY, PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
ADVANCE TECHNOLOGICAL RADIOLOGY, PA
Authorized official
ANTHONY T ROSA MD (OWNER)
(863) 421-9393
Entity
Organization
Contact information
Practice address
315 E CENTRAL AVE, WINTER HAVEN, FL 33880-3047
(863) 295-5674
(863) 295-5719
Mailing address
PO BOX 2159, HAINES CITY, FL 33845-2159
(863) 421-9393
(863) 419-8774
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024615200
—
FL
Enumeration date
08/03/2021
Last updated
08/10/2021
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