Provider Demographics
NPI:1871806133
Name:IMEDICAL DIAGNOSTIC IMAGING CENTER OF NAPLES, LLC
Entity type:Organization
Organization Name:IMEDICAL DIAGNOSTIC IMAGING CENTER OF NAPLES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:STERNBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-430-4674
Mailing Address - Street 1:1350 TAMIAMI TRAIL NORTH
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5209
Mailing Address - Country:US
Mailing Address - Phone:239-430-4674
Mailing Address - Fax:
Practice Address - Street 1:500 WEST MAIN STREET
Practice Address - Street 2:SUITE 108
Practice Address - City:BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11702-3028
Practice Address - Country:US
Practice Address - Phone:631-240-2277
Practice Address - Fax:631-517-8007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-15
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC87832085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty