SUMMERLIN IMAGING CENTER LLC – NPI #1720536154
Radiology

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

SUMMERLIN IMAGING CENTER LLC is a radiologist located in ORANGE PARK, FL. NPPES has assigned the NPI number 1720536154 to SUMMERLIN IMAGING CENTER LLC on September 14, 2016. It is a Type-2 NPI, indicating this NPI number is associated with an organization. SUMMERLIN IMAGING CENTER LLC is also known by the name PARK AVENUE IMAGING. The primary taxonomy selected by this provider is 2085R0202X from the Health Care Provider Taxonomy code set, which is classified as Radiology, specializing in Diagnostic Radiology

The NPI profile was previously updated about 6 years ago on Aug 25, 2020. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for SUMMERLIN IMAGING CENTER LLC below.

NPI Profile for
SUMMERLIN IMAGING CENTER LLC

NPI Number
1720536154
Enumeration Date

(more than 9 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
SUMMERLIN IMAGING CENTER LLC
Other Name: PARK AVENUE IMAGING
Primary location
2128 PARK AVE
ORANGE PARK, FL 32073
Phone: (904) 375-8884 Fax: (904) 375-8887
Mailing address
6415 LAKE WORTH RD STE 102
GREENACRES, FL 33463-3009
Phone: (561) 331-0808 Fax: (561) 237-6034
Organization Subpart
No
Authorized Official
BRADFORD PETERS
CFO
Phone: (561) 331-0808
Updated
Certification Date
Aug 25, 2020

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for SUMMERLIN IMAGING CENTER LLC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERAHCC LICENSEFLHCC10650
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
2085R0202X
- Radiology / Diagnostic Radiology (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.