Organization Name: | AMERICAN RADIOLOGY SERVICES BANYAN CENTER LLC |
NPI Number: | 1003922832 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARK JOHN MARZANO (PRESIDENT) |
Mailing Address: | 1350 Tamiami Trl N Suite101 Naples |
State: | FL US |
Postal Code: | 341025203 |
Phone Number: | 2394304674 |
Fax Number: | 2392638189 |
NPI Enumeration Date: | 08/22/2006 |
NPI Last Update Date: | 09/27/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0200X |
License Number: | HCC2420 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Radiology |
Taxonomy Definition: |