Active NPI
Divine Breast Imaging LLC
- Radiology Clinic/Center
- St Petersburg, FL
National Provider Identifier
1164359238
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiology Clinic/Center
- Legal business name
- DIVINE BREAST IMAGING LLC
- Practice address
- 4336 4TH St N Ste B
Saint Petersburg, FL 33703-4701 - Phone
- (727) 692-6596
- NPI assigned
- May 5, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Robert Galiardo
- Title
- Coo
- Phone
- (727) 608-3013
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiology Clinic/Center | 261QR0200X | Primary |
Addresses
Primary practice location
4336 4TH St N Ste B
Saint Petersburg, FL 33703-4701
Mailing address
4336 4TH St N Ste B
Saint Petersburg, FL 33703-4701
National Provider Directory
National Provider DirectoryLocations
4336 4th St N
Ste B
Saint Petersburg, FL 33703
Phone (727) 692-6596
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1777939200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1783296000000",
"number": "1164359238",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4336 4TH ST N STE B",
"city": "SAINT PETERSBURG",
"state": "FL",
"postal_code": "337034701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4336 4TH ST N STE B",
"city": "SAINT PETERSBURG",
"state": "FL",
"postal_code": "337034701",
"telephone_number": "727-692-6596"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DIVINE BREAST IMAGING LLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-05-05",
"last_updated": "2026-07-06",
"certification_date": "2026-07-06",
"status": "A",
"authorized_official_last_name": "GALIARDO",
"authorized_official_first_name": "ROBERT",
"authorized_official_title_or_position": "COO",
"authorized_official_telephone_number": "727-608-3013"
},
"taxonomies": [
{
"code": "261QR0200X",
"taxonomy_group": "",
"desc": "Clinic/Center, Radiology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in St Petersburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.