NPIMap

Organization Active NPI

East Central Florida Outpatient Imaging, LLC

Doing business as Radiology Associates Daytona Beach Shores

  • Vascular & Interventional Radiology Physician
  • Daytona Beach Shores, FL
National Provider Identifier
1457927469
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
Legal business name
EAST CENTRAL FLORIDA OUTPATIENT IMAGING, LLC
Doing business as
Radiology Associates Daytona Beach Shores
Practice address
3048 S Atlantic Ave Ste 102
Daytona Beach Shores, FL 32118-6102
Phone
(386) 274-7118
Fax
(386) 276-6173
NPI assigned
Jun 1, 2021
Last updated
Sep 4, 2024By 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 Sep 4, 2024

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

Authorized official

Name
Lisa Adams
Title
Ceo
Phone
(386) 274-7118

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X NU Primary

Addresses

Primary practice location

3048 S Atlantic Ave Ste 102
Daytona Beach Shores, FL 32118-6102

Mailing address

PO Box 678454
Dallas, TX 75267-8454

Other names 1

  • Radiology Associates Daytona Beach Shores Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2312339Radiology Associates Daytona Beach Shores3048 S Atlantic Avenue Suite 102, Daytona Beach Shores, FL 32118Certificate of waiverOct 8, 2026

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": "1622505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725408000000",
    "number": "1457927469",
    "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": "3048 S ATLANTIC AVE STE 102",
            "city": "DAYTONA BEACH SHORES",
            "state": "FL",
            "postal_code": "321186102",
            "telephone_number": "386-274-7118",
            "fax_number": "386-276-6173"
        }
    ],
    "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": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "386-274-7118"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Radiology Associates Daytona Beach Shores",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Daytona Beach Shores, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.