Coral Reef Radiology Associates PA

Organization Active NPI Diagnostic Radiology Physician · Village of Palmetto Bay, FL

NPI 1972600385 · NPPES record last updated Jul 29, 2008

Key facts

NPI
1972600385
Entity type
Organization (NPI type 2)
Primary specialty
Diagnostic Radiology Physician 2085R0202X
Legal business name
CORAL REEF RADIOLOGY ASSOCIATES PA
Practice address
9333 SW 152ND St
Village of Palmetto Bay, FL 33157-1778
Phone
(772) 621-3000
Fax
(772) 621-3181
NPI assigned
Sep 20, 2006
Organization subpart
No

Authorized official

Name
Mitchell Gregg, M.D.
Title
Registered Agent
Phone
(772) 621-3059

Practitioners 11

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

National Provider Directory

Locations

2785 S Bay St
Eustis, FL 32726
Phone (352) 589-5171

1704 Citrus Blvd
Leesburg, FL 34748
Phone (352) 365-9553

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician
Group: 193400000X SINGLE SPECIALTY GROUP
2085R0202X Yes

Addresses

Primary practice location

9333 SW 152ND St
Village of Palmetto Bay, FL 33157-1778

Mailing address

900 E Prima Vista Blvd
Suite 200
Port St Lucie, FL 34952-2366
Phone (772) 621-3000

Other identifiers

IdentifierTypeStateIssuer
062960000MedicaidFL

Other providers in Village of Palmetto Bay, FL

All providers in Village of Palmetto Bay, FL · Diagnostic Radiology Physician in Florida

Sources for this page

Verify at the official NPI Registry.