NPIMap

Organization Active NPI

Advanced Imaging of Port Charlotte

  • Diagnostic Radiology Physician
  • Port Charlotte, FL
National Provider Identifier
1225361850
Registry record updated Oct 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
HCC6183 Issued in FL
Legal business name
ADVANCED IMAGING OF PORT CHARLOTTE
Practice address
2625 Tamiami Trail
Unit 1
Port Charlotte, FL 33952
Phone
(941) 235-4646
Fax
(941) 235-4667
NPI assigned
Sep 15, 2009
Last updated
Oct 28, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Thomas FabianNPI 1669466462
Title
Medical Director
Phone
(941) 235-4646

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X HCC6183 FL Primary

Addresses

Primary practice location

2625 Tamiami Trail
Unit 1
Port Charlotte, FL 33952

Mailing address

2625 Tamiami Trail
Unit 1
Port Charlotte, FL 33952
Phone (941) 235-4646

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 61

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 61

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1252972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256688000000",
    "number": "1225361850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 TAMIAMI TRAIL",
            "address_2": "UNIT 1",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "33952",
            "telephone_number": "941-235-4646",
            "fax_number": "941-235-4667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 TAMIAMI TRAIL",
            "address_2": "UNIT 1",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "33952",
            "telephone_number": "941-235-4646",
            "fax_number": "941-235-4667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED IMAGING OF PORT CHARLOTTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-15",
        "last_updated": "2009-10-28",
        "status": "A",
        "authorized_official_last_name": "FABIAN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "941-235-4646",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "HCC6183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.