RADIOLOGY REGIONAL CENTER, PA (NPI# 1407809262) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407809262 |
| Entity Type | Organization |
| Organization Name | RADIOLOGY REGIONAL CENTER, PA |
| Practice Address |
3680 Broadway Fort Myers FL 33901-8005 |
| Mailing Address |
3660 Broadway Fort Myers FL 33901-8005 |
| Practice Telephone | 2399362316 |
| Mailing Telephone | 2399366300 |
| Mailing Fax Number | 2399316373 |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2019-06-19 |
| Authorized Official Name | MR. DAVE PALKOVICH (ADMINISTRATOR) |
| Authorized Official Telephone | 2399362316 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GROUP UHC-PROFESSIONAL | 1605401 | 01 | |
| FL | 054636400 | 05 | |
| GROUP BCBS | 77185 | 01 | |
| GROUP UHC-OFFICE | 3406551 | 01 |
| Street Address |
3680 BROADWAY |
| City | FORT MYERS |
| State | FL |
| Zip Code | 33901-8005 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952393464 | Michael R Theobald | Radiology | 3680 Broadway, Fort Myers, FL 33901-8005 | 2005-08-19 |
| 1619310752 | Kevin Kadakia | Radiology | 3680 Broadway, Fort Myers, FL 33901-8005 | 2013-04-08 |
| 1760774327 | Danielle Matta | Radiology | 3680 Broadway, Fort Myers, FL 33901-8005 | 2011-05-13 |
| 1760718845 | Maximo Jose Santiago | Radiology | 3680 Broadway, Fort Myers, FL 33901-8005 | 2009-10-26 |
| 1194994509 | Richard Dominick Pagliara Jr. | Radiology | 3680 Broadway, Fort Myers, FL 33901-8005 | 2008-02-29 |
| 1447458971 | Darius Biskup | Radiology | 3680 Broadway, Fort Myers, FL 33901-8005 | 2007-07-05 |
| 1922202704 | Robert Perez | Radiology | 3680 Broadway, Fort Myers, FL 33901-8005 | 2007-06-13 |
| 1457553398 | Paul C Makhlouf | Radiology | 3680 Broadway, Fort Myers, FL 33901-8005 | 2007-06-04 |
| 1871707265 | Cyrus Anderson | Radiology | 3680 Broadway, Fort Myers, FL 33901-8005 | 2007-05-09 |
| 1720091937 | William N. Wiley | Radiology | 3680 Broadway, Fort Myers, FL 33901-8005 | 2006-08-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811536972 | Daniel Wolfe | Speech-Language Pathologist | 3375 Evans Avenue, Fort Myers, FL 33901 | 2020-01-06 |
| 1841764065 | Medicab Transportation, LLC | Ambulance | 3049 Cleveland Avenue, Suite 275, Fort Myers, FL 33901 | 2019-01-22 |
| 1760963649 | Jamies Home Care Services LLC | Home Health | 1944 Suwanee Ave, Fort Myers, FL 33901 | 2018-08-28 |
| 1942673900 | Adriana Ramnarine | Dietitian, Registered | 2727 Winkler Ave., Fort Myers, FL 33901 | 2015-11-12 |
| 1215327093 | Carecommunity Inc. | Foster Care Agency | 4066 Evans Ave Ste 4, Fort Myers, FL 33901 | 2015-01-30 |
| 1013327832 | Neck Pain Back Pain and Headache Relief Center of Ft. Myers, LLC | Chiropractor | 4144 Cleveland Ave, Suite 2, Ft. Myers, FL 33901 | 2014-05-01 |
| 1588087076 | Larry Philip Garrett | Family Medicine | 3543 Stuart Ct, Fort Myers, FL 33901 | 2014-02-04 |
| 1144657479 | Janet M Michael | Registered Nurse | 3763 Evans Ave., Fort Myers, FL 33901 | 2013-10-01 |
| 1366879785 | Gina Lee Guerrero | Licensed Practical Nurse | 3736 Evans Ave, Fort Myers, FL 33901 | 2013-09-30 |
| 1396186649 | Ronald Edward Trapp | Dentist | 2470 Edison Ave, Project Dentists Care of Sw Florida, Fort Myers, FL 33901 | 2013-07-16 |
| Find all providers in zip 33901 | ||||
| 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 |
|---|---|---|---|---|
| 1669997961 | Sw Florida Radiology LLC | Radiology | 3949 Evans Ave Ste 301b, Fort Myers, FL 33901-9313 | 2017-08-08 |
| 1346698669 | Irving Radiology, Inc | Radiology | 4110 Center Pointe Dr Ste 210, Fort Myers, FL 33916 | 2016-05-26 |
| 1851752257 | Lillian Palmon | Radiology | 11250 Mahogany Run, Fort Myers, FL 33913-8114 | 2016-03-11 |
| 1770739260 | Winston Dacosta Irving | Radiology | 1244 Walden Dr, Fort Myers, FL 33901 | 2008-08-15 |
| 1366646424 | Louis Thomas Magas | Radiology | 6311 South Pointe Blvd, Fort Myers, FL 33919-4901 | 2007-06-13 |
| 1851330153 | David S Schwartz | Radiology | 3230 Cypress Marsh Dr, Fort Myers, FL 33905-6250 | 2006-06-05 |
| 1851345862 | Otto J Kunst | Radiology | 13151 Parkline Dr, Fort Myers, FL 33913-7929 | 2006-05-22 |
| 1124078241 | Adam Fueredi | Radiology | 3660 Broadway, Fort Myers, FL 33901-8005 | 2006-05-11 |
| 1235187808 | Gail M Santucci | Radiology | 8791 Conference Dr, Suite 1, Fort Myers, FL 33919-5822 | 2006-05-05 |
| 1538121116 | Laurie Lynn Gutstein | Radiology | 6013 W Riverside Dr, Fort Myers, FL 33919-1636 | 2006-04-06 |
| Find all providers in FORT MYERS | ||||
| City | FORT MYERS |
| Zip Code | 33901 |
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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.