NPIMap

Organization Active NPI

RX Imaging of SWFL LLC

  • Diagnostic Radiology Physician
  • Cape Coral, FL
National Provider Identifier
1356711329
Registry record updated Oct 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
JR44872000 Issued in FL
Legal business name
RX IMAGING OF SWFL LLC
Practice address
506 SE 47TH Ter
Suite a
Cape Coral, FL 33904-8517
Phone
(239) 541-5444
Fax
(239) 471-2674
NPI assigned
Oct 2, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2015

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

Authorized official

Name
Alan Lee Tannenbaum, M.D.
Title
Owner
Phone
(239) 541-5444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X JR44872000 FL Primary

Addresses

Primary practice location

506 SE 47TH Ter
Suite a
Cape Coral, FL 33904-8517

Mailing address

506 SE 47TH Ter
Suite a
Cape Coral, FL 33904-8517
Phone (239) 541-5444

Other identifiers 1

IdentifierTypeStateIssuer
013199600MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
RX Imaging of SWFL LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

506 SE 47th Ter
Ste A
Cape Coral, FL 33904
Phone (239) 541-5444

NPI Registry JSON

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

{
    "created_epoch": "1443744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443744000000",
    "number": "1356711329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 SE 47TH TER",
            "address_2": "SUITE A",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339048517",
            "telephone_number": "239-541-5444",
            "fax_number": "239-471-2674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 SE 47TH TER",
            "address_2": "SUITE A",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339048517",
            "telephone_number": "239-541-5444",
            "fax_number": "239-471-2674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RX IMAGING OF SWFL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-02",
        "last_updated": "2015-10-02",
        "status": "A",
        "authorized_official_last_name": "TANNENBAUM",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-541-5444",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "JR44872000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "013199600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.