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East Central Florida Outpatient Imaging LLC

Organization Active NPI Diagnostic Radiology Physician · New Smyrna Beach, FL

NPI 1255907267 · NPPES record last updated Oct 29, 2021

Key facts

NPI
1255907267
Entity type
Organization (NPI type 2)
Primary specialty
Diagnostic Radiology Physician 2085R0202X
Legal business name
EAST CENTRAL FLORIDA OUTPATIENT IMAGING LLC
Practice address
1998 State Road 44 Ste 3
New Smyrna Beach, FL 32168-8303
Phone
(386) 274-7118
Fax
(386) 274-6173
NPI assigned
Jun 1, 2021
Organization subpart
Yes
Parent organization (as reported)
EAST CENTRAL FLORIDA OUTPATIENT IMAGING LLC

Authorized official

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

Corporate family (same tax ID) 10

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

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2263882Radiology Associates New Smyrna Beach
1998 State Road 44, Suite 3, New Smyrna Beach, FL 32168		Certificate of waiverJul 5, 2028

National Provider Directory

Tax ID family
East Central Florida Outpatient Imaging LLC (11 organizations share this tax ID)
Part of
East Central Florida Outpatient Imaging LLC

Locations

1998 State Road 44
Ste 2
New Smyrna Beach, FL 32168

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 2085R0202X Yes

Addresses

Primary practice location

1998 State Road 44 Ste 3
New Smyrna Beach, FL 32168-8303

Mailing address

PO Box 678454
Dallas, TX 75267-8454

Other names

  • Radiology Associates New Smyrna Beach Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 29, 2021.

{
    "created_epoch": "1622505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635465600000",
    "number": "1255907267",
    "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": "1998 STATE ROAD 44 STE 3",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321688303",
            "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": "2021-06-01",
        "last_updated": "2021-10-29",
        "certification_date": "2021-10-29",
        "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": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Radiology Associates New Smyrna Beach",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Radiology Associates New Smyrna Beach",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New Smyrna Beach, FL

All providers in New Smyrna Beach, FL · Diagnostic Radiology Physician in Florida

Sources for this page

Verify at the official NPI Registry.