PROFESSIONAL RADIOLOGY ASSOCIATES PA (NPI# 1790224285) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790224285 |
| Entity Type | Organization |
| Organization Name | PROFESSIONAL RADIOLOGY ASSOCIATES PA |
| Other Organization Name | ALLIANCE MRI OF FLORIDA |
| Practice Address |
517 Health Blvd Daytona Beach FL 32114-1493 |
| Mailing Address |
100 Bayview Cir 400 Newport Beach CA 92660 |
| Practice Telephone | 9492425808 |
| Mailing Telephone | 9492425592 |
| Enumeration Date | 2017-02-16 |
| Last Update Date | 2017-02-16 |
| Authorized Official Name | JAYSON LORD (PRESIDENT) |
| Authorized Official Telephone | 9043792226 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0208X |
Clinic/Center Specialization: Radiology, Mobile |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Alliance MRI of Florida | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912446766 | Professional Radiology Associates Pa | Clinic/Center | 2720 Rebecca Ln, 104, Orange City, FL 32763-8327 | 2017-02-13 |
| 1538551320 | Professional Radiology Associates Pa | Clinic/Center | 4634 Summerdale Dr, Pace, FL 32571-1368 | 2015-03-03 |
| Street Address |
517 HEALTH BLVD |
| City | DAYTONA BEACH |
| State | FL |
| Zip Code | 32114-1493 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336193044 | Kandace F Vagovic | Physician Assistant | 517 Health Blvd, Daytona Beach, FL 32114-1493 | 2006-05-19 |
| 1508260134 | Prc Associates, LLC | Pain Medicine | 517 Health Blvd, Daytona Beach, FL 32114-1493 | 2014-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376161380 | Evolution Health & Performance LLC | Physician Assistant | 244 S. Palmetto Ave, Daytona Beach, FL 32114 | 2020-07-07 |
| 1407480189 | Kierra Imani Kinsey | Behavior Technician | 1128-a Beville Rd, Daytona Beach, FL 32114 | 2020-03-02 |
| 1043776057 | Outreach Community Care Network Inc | Pharmacy | 240 N. Frederick Avenue, Daytona Beach, FL 32114 | 2019-02-14 |
| 1033681861 | Katherine Proppe | Specialist/Technologist | 1 Aerospace Blvd, Daytona Beach, FL 32114 | 2018-12-18 |
| 1841765047 | Anna L Smith | Nurse Practitioner | 339 Bill France Blvd Ste C, Daytona Beach, FL 32114 | 2018-10-04 |
| 1154806933 | Steve Anthony Lee | Family Medicine | 731 N. Clyde Morris Blvd, Daytona Beach, FL 32114 | 2018-09-27 |
| 1285116491 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1348 W International Speedway Blvd Ste 2, Daytona Beach, FL 32114 | 2018-09-04 |
| 1770085656 | Merina Lee | Occupational Therapist | 1159 Australia Ave., Daytona Beach, FL 32114 | 2018-03-06 |
| 1346752755 | Hand & Upper Extremity Surgery of Daytona Beach, LLC | Non-Pharmacy Dispensing Site | 1241 Ridgewood Ave, Daytona Beach, FL 32114 | 2017-10-26 |
| 1104347053 | Harry Herman Blanke IIi | Family Medicine | 201 N Clyde Morris Blvd, Suite 200, Halifax Health Family Medicine Residency Program, Daytona Beach, FL 32114 | 2017-06-30 |
| Find all providers in zip 32114 | ||||
| Taxonomy Code | 261QR0208X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology, Mobile |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437770450 | Mobile Medical Scanner LLC | Clinic/Center | 3911 Sw 47th Ave Ste 901, Davie, FL 33314-2818 | 2020-04-30 |
| 1164078937 | Des Mobile Diagnostics Imaging Inc | Clinic/Center | 10820 W Old Cutler Rd, Miami, FL 33170-6551 | 2019-08-16 |
| 1093278467 | America Diagnostic Inc | Clinic/Center | 100 E Linton Blvd Ste 204a, Delray Beach, FL 33483-3336 | 2019-04-11 |
| 1770066359 | S&s Life Scan Corp | Clinic/Center | 1118 Nw 124th Ct # 1118, Miami, FL 33182-2447 | 2018-09-10 |
| 1174017743 | National Medical Providers LLC | Clinic/Center | 11564 Puerto Blvd, Boynton Beach, FL 33437-4028 | 2018-06-18 |
| 1043720022 | Patient First Diagnostics | Clinic/Center | 575 Ne 5th Ter Apt 753, Fort Lauderdale, FL 33301-2170 | 2017-10-04 |
| 1922537489 | Portable Ultrasound Services Inc | Clinic/Center | 11021 Sw 44 Street, Miami, FL 33165 | 2017-06-08 |
| 1003343740 | Qualis Diagnostics LLC | Clinic/Center | 1900 N Bayshore Dr Ste 1a162, Miami, FL 33132-3001 | 2017-05-12 |
| 1114468402 | Navarro Mobile Imaging Corp. | Clinic/Center | 100 Bayview Drive, Apartment :211, Sunny Isles Beach, FL 33160-4781 | 2017-03-20 |
| 1760932727 | Ultra-dx, Inc | Clinic/Center | 222 Andalusia Dr, Palm Beach Gardens, FL 33418-1736 | 2016-10-13 |
| Find all providers with the same taxonomy | ||||
| City | DAYTONA BEACH |
| Zip Code | 32114 |
Please comment or provide details below to improve the information on PROFESSIONAL RADIOLOGY ASSOCIATES PA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.