BLUE RADIOLOGY SERVICES LLC (NPI# 1174976468) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174976468 |
| Entity Type | Organization |
| Organization Name | BLUE RADIOLOGY SERVICES LLC |
| Practice Address |
10101 Forest Hill Blvd Wellington FL 33414-6103 |
| Mailing Address |
1155 S Congress Ave Ste C Palm Springs FL 33406-5114 |
| Practice Telephone | 5617661301 |
| Practice Fax Number | 5616930539 |
| Mailing Telephone | 5617661300 |
| Mailing Fax Number | 5616930539 |
| Enumeration Date | 2016-07-21 |
| Last Update Date | 2020-11-04 |
| Authorized Official Name | DANIELA GHIRAGOSSIAN (PRACTICE ADMINISTRATOR) |
| Authorized Official Telephone | 5612686509 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 39200 Hooker Hwy, Belle Glade, FL 334305368 | 5617661300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003357161 | Blue Radiology Services LLC | Radiology | 8330 Lakewood Ranch Blvd, Lakewood Ranch, FL 34202-5174 | 2017-03-09 |
| 1629519780 | Blue Radiology Services LLC | Radiology | 206 2nd St E, Bradenton, FL 34208-1042 | 2017-03-09 |
| Street Address |
10101 FOREST HILL BLVD |
| City | WELLINGTON |
| State | FL |
| Zip Code | 33414-6103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891788667 | Leonid Zaslavskiy | Anesthesiology | 10101 Forest Hill Blvd, Wellington, FL 33414-6103 | 2005-08-26 |
| 1033734462 | Stacey Ann Loffredo | Nurse Anesthetist, Certified Registered | 10101 Forest Hill Blvd, Wellington, FL 33414-6103 | 2020-06-11 |
| 1881213536 | Autumn Lee Davis | Student in an Organized Health Care Education/Training Program | 10101 Forest Hill Blvd, Wellington, FL 33414-6103 | 2020-04-13 |
| 1053940320 | Courtney Konchan | Student in an Organized Health Care Education/Training Program | 10101 Forest Hill Blvd, Wellington, FL 33414-6103 | 2020-04-07 |
| 1841829744 | Mirsha Stiven | Student in an Organized Health Care Education/Training Program | 10101 Forest Hill Blvd, Wellington, FL 33414-6103 | 2020-04-03 |
| 1912534520 | Ashleigh Dugas Dupuy | Student in an Organized Health Care Education/Training Program | 10101 Forest Hill Blvd, Wellington, FL 33414-6103 | 2020-03-24 |
| 1982163515 | Winta Haile Assefaw | Student in an Organized Health Care Education/Training Program | 10101 Forest Hill Blvd, Wellington, FL 33414-6103 | 2019-03-13 |
| 1629537287 | Anastasia Veresciac | Student in an Organized Health Care Education/Training Program | 10101 Forest Hill Blvd, Wellington, FL 33414-6103 | 2019-03-13 |
| 1609334531 | Tamara Coleburn | Nurse Practitioner | 10101 Forest Hill Blvd, Wellington, FL 33414-6103 | 2019-03-11 |
| 1811455173 | Andrea Erickson | Physician Assistant | 10101 Forest Hill Blvd, Wellington, FL 33414-6103 | 2019-03-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932707247 | Juana Maria Gonzales | Home Health | 2766 Penhall Ct, Wellington, FL 33414 | 2020-10-09 |
| 1821601089 | Wellington Rehab and Health Center, LLC | Skilled Nursing Facility | 10330 Nu Vista Ave, Wellington, FL 33414 | 2020-08-27 |
| 1730661158 | Michelle Alexis Anagnostu | Nurse Practitioner | 1447 Medical Park Blvd Suite 406, Wellington, FL 33414 | 2018-09-01 |
| 1932686193 | Borola Inc | Occupational Therapy Assistant | 1985 Canterbury Circle, Wellington, FL 33414 | 2018-07-20 |
| 1841783156 | Kid'z World Advance Inc | Behavioral Analyst | 2400 Wrotham Ter, Wellington, FL 33414 | 2018-06-11 |
| 1134619489 | Devin Michael Scheller | Counselor | 2077 Vinings Circle Apt 1303, Wellington, FL 33414 | 2018-05-12 |
| 1942726617 | Amanda Hardy | Social Worker | 11120 South Way, Suite 1, Wellington, FL 33414 | 2017-08-15 |
| 1467976423 | Dawn Carnegia Blackshear | Nurse Practitioner | 1397 Medical Park Blvd Ste 480, Wellington, FL 33414 | 2017-08-01 |
| 1508390238 | Morgan Mccollum | Speech-Language Pathologist | 2158 Polo Gardens Dr Apt 203, Wellington, FL 33414 | 2017-04-19 |
| 1003369786 | Memite G Charlemagne | Registered Nurse | 184 Berenger Walk, Royal Palm Beach, FL 33414 | 2016-07-28 |
| Find all providers in zip 33414 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053963207 | The Rave Clinic, LLC | Radiology | 2767 S State Road 7, Wellington, FL 33414-9320 | 2019-07-09 |
| 1851754980 | South Florida Diagnostic Resources LLC | Radiology | 10754 Versailles Blvd, Wellington, FL 33449-8086 | 2016-04-05 |
| 1386034668 | Advanced Metropolitan Radiology LLC | Radiology | 9425 Worswick Ct, Wellington, FL 33414-6423 | 2015-01-26 |
| 1962590133 | Barbara Ann Nitsch | Radiology | 2618 Players Ct, Wellington, FL 33414-6296 | 2006-10-11 |
| 1326093816 | Eric M Baumel | Radiology | 12788 Forest Hill Blvd, Suite 1003, Wellington, FL 33414-4703 | 2006-05-23 |
| 1952353856 | Western Imaging Inc | Radiology | 11101 S Crown Way, Suite 1, Wellington, FL 33414-8792 | 2006-05-17 |
| 1003868878 | Richard Steven Gordon | Radiology | 10957 Northgreen Dr, Wellington, FL 33449-8054 | 2006-05-17 |
| 1548212285 | Gabrielle Kater | Radiology | 12798 W Forest Hill Blvd, Suit 301a, Wellington, FL 33414-4750 | 2006-05-17 |
| 1356393086 | Thomas Kirchner | Radiology | 3461 Fairlane Farms Road, Wellington, FL 33414-8792 | 2006-05-17 |
| 1619948387 | Bradley M Cohen | Radiology | 2565 S State Road 7, Wellington, FL 33414-9368 | 2006-01-30 |
| Find all providers in WELLINGTON | ||||
| City | WELLINGTON |
| Zip Code | 33414 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.