NPIMap

Organization Active NPI

Advance Technological Radiology, PA

  • Diagnostic Radiology Physician
  • Winter Haven, FL
National Provider Identifier
1851065981
Registry record updated Aug 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
ADVANCE TECHNOLOGICAL RADIOLOGY, PA
Practice address
315 E Central Ave
Winter Haven, FL 33880-3047
Phone
(863) 295-5674
Fax
(863) 295-5719
NPI assigned
Aug 3, 2021
Last updated
Aug 10, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
ADVANCE TECHNOLOGICAL RADIOLOGY, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 10, 2021

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

Authorized official

Name
Anthony T Rosa, MDNPI 1558497438
Title
Owner
Phone
(863) 421-9393

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X NU Primary

Addresses

Primary practice location

315 E Central Ave
Winter Haven, FL 33880-3047

Mailing address

PO Box 2159
Haines City, FL 33845-2159
Phone (863) 421-9393

Other identifiers 1

IdentifierTypeStateIssuer
024615200MedicaidFL

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL 863-421-9622 Health Information Exchange (HIE)
Direct Messaging Address sorn@atradiology.cc Health Information Exchange (HIE)

National Provider Directory

National Provider Directory
Tax ID family
Advance Technological Radiology PA3 organizations share this tax ID, including this one
Part of
Advance Technological Radiology PA

Other organizations with this tax ID 2

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

Locations

714 Ingraham Ave
Haines City, FL 33844

315 E Central Ave
Winter Haven, FL 33880
Phone (863) 295-5674

Practitioners & affiliated clinicians

Practitioners 16

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 16

NPI Registry JSON

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

{
    "created_epoch": "1627948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628553600000",
    "number": "1851065981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2159",
            "city": "HAINES CITY",
            "state": "FL",
            "postal_code": "338452159",
            "telephone_number": "863-421-9393",
            "fax_number": "863-419-8774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 E CENTRAL AVE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338803047",
            "telephone_number": "863-295-5674",
            "fax_number": "863-295-5719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE TECHNOLOGICAL RADIOLOGY, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVANCE TECHNOLOGICAL RADIOLOGY, PA",
        "enumeration_date": "2021-08-03",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A",
        "authorized_official_last_name": "ROSA",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "863-421-9393",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "024615200",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "863-421-9622",
            "affiliation": "N",
            "endpointDescription": "Fax Scheduling",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "714 Ingraham Ave",
            "city": "Haines City",
            "state": "FL",
            "country_code": "US",
            "postal_code": "338444351",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sorn@atradiology.cc",
            "affiliation": "N",
            "endpointDescription": "Billing Dept",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "714 Ingraham Ave",
            "city": "Haines City",
            "state": "FL",
            "country_code": "US",
            "postal_code": "338444351",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 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.