NPIMap

Organization Active NPI

Central Florida Imaging Associates, LLC

  • Diagnostic Radiology Physician
  • Lake Wales, FL
National Provider Identifier
1326378951
Registry record updated Mar 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
CENTRAL FLORIDA IMAGING ASSOCIATES, LLC
Practice address
410 11TH Street
Lake Wales, FL 33853-4203
Phone
(863) 678-2761
Fax
(813) 985-8006
NPI assigned
Jan 4, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2015

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

Authorized official

Name
Mr. Ellis B. Norsoph, MD
Title
President/Ceo
Phone
(813) 899-6220

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085B0100X
Neuroradiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085N0700X
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X Primary
Vascular & Interventional Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0204X

Addresses

Primary practice location

410 11TH Street
Lake Wales, FL 33853-4203

Mailing address

PO Box 23027
Tampa, FL 33623-3027
Phone (813) 899-6220

Other identifiers 2

IdentifierTypeStateIssuer
4007OtherFLSTATE LICENSE NUMBER
001844600MedicaidFL

National Provider Directory

National Provider Directory

Locations

410 S 11th St
Lake Wales, FL 33853
Phone (863) 676-1433

Practitioners & affiliated clinicians

Practitioners 8

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": "1262563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427328000000",
    "number": "1326378951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23027",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336233027",
            "telephone_number": "813-899-6220",
            "fax_number": "813-985-8006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 11TH STREET",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534203",
            "telephone_number": "863-678-2761",
            "fax_number": "813-985-8006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL FLORIDA IMAGING ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-04",
        "last_updated": "2015-03-26",
        "status": "A",
        "authorized_official_last_name": "NORSOPH",
        "authorized_official_first_name": "ELLIS",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "813-899-6220",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Body Imaging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Neuroradiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "4007",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001844600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Wales, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2015; 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.