NPIMap

Organization Active NPI

East Central Florida Outpatient Imaging LLC

Doing business as Radiology Associates Port Orange West

  • Diagnostic Radiology Physician
  • Port Orange, FL
National Provider Identifier
1225606296
Registry record updated Aug 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
EAST CENTRAL FLORIDA OUTPATIENT IMAGING LLC
Doing business as
Radiology Associates Port Orange West
Practice address
5440 S. Williamson Blvd
Suite 102
Port Orange, FL 32128
Phone
(386) 274-7118
Fax
(386) 274-6173
NPI assigned
Jun 15, 2021
Last updated
Aug 30, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
EAST CENTRAL FLORIDA OUTPATIENT IMAGING LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 30, 2021

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

Authorized official

Name
Al Falco
Title
Ceo
Phone
(386) 274-7118

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X NU Primary

Addresses

Primary practice location

5440 S. Williamson Blvd
Suite 102
Port Orange, FL 32128

Mailing address

PO Box 678454
Dallas, TX 75267-8454

Other names 1

  • Radiology Associates Port Orange West Doing business as

National Provider Directory

National Provider Directory
Tax ID family
East Central Florida Outpatient Imaging LLC11 organizations share this tax ID, including this one
Part of
East Central Florida Outpatient Imaging LLC

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 22

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 22

NPI Registry JSON

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

{
    "created_epoch": "1623715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630281600000",
    "number": "1225606296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 678454",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752678454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5440 S. WILLIAMSON BLVD",
            "address_2": "SUITE 102",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "32128",
            "telephone_number": "386-274-7118",
            "fax_number": "386-274-6173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST CENTRAL FLORIDA OUTPATIENT IMAGING LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EAST CENTRAL FLORIDA OUTPATIENT IMAGING LLC",
        "enumeration_date": "2021-06-15",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A",
        "authorized_official_last_name": "FALCO",
        "authorized_official_first_name": "AL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "386-274-7118"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Radiology Associates Port Orange West",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Orange, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2021; 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.