NPIMap

Organization Active NPI

Radiology Associates of Tallahassee PA

  • Diagnostic Radiology Physician
  • Perry, FL
National Provider Identifier
1255909131
Registry record updated Jun 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
RADIOLOGY ASSOCIATES OF TALLAHASSEE PA
Practice address
333 N Byron Butler Pkwy
Perry, FL 32347-2300
Phone
(850) 584-0800
NPI assigned
Jun 16, 2021
Organization subpart
Yes
Parent organization
RADIOLOGY ASSOCIATES OF TALLAHASSEE PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 16, 2021

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

Authorized official

Name
John R Detelich
Title
Ceo
Phone
(850) 878-4127

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

333 N Byron Butler Pkwy
Perry, FL 32347-2300

Mailing address

P O Box 20747
Tampa, FL 33662-0747

National Provider Directory

National Provider Directory
Tax ID family
Radiology Associates of6 organizations share this tax ID, including this one
Part of
Radiology Associates of

Other organizations with this tax ID 5

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

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1623801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623801600000",
    "number": "1255909131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 20747",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336620747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 N BYRON BUTLER PKWY",
            "city": "PERRY",
            "state": "FL",
            "postal_code": "323472300",
            "telephone_number": "850-584-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIOLOGY ASSOCIATES OF TALLAHASSEE PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RADIOLOGY ASSOCIATES OF TALLAHASSEE PA",
        "enumeration_date": "2021-06-16",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A",
        "authorized_official_last_name": "DETELICH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "850-878-4127"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perry, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.