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RADIOLOGY ASSOCIATES OF TALLAHASSEE PA
NPI 1003291535
Radiology - Diagnostic Radiology in Tallahassee, FL

Active since July 27, 2015CLIA 10D1100630 · Waiver
1300 MICCOSUKEE RD, TALLAHASSEE, FL 32308(850) 431-1155 Get Directions Write a Review

NPPES record last updated: July 27, 2015. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Radiology Associates Of Tallahassee Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RADIOLOGY ASSOCIATES OF TALLAHASSEE PA (NPI 1003291535) is a healthcare organization registered as a diagnostic radiology in Tallahassee, Florida and active in the NPI registry since July 2015. The organization holds a CLIA Waiver certificate valid through June 8, 2027 and lists John R Detelich, Ceo, as its authorized official.

NPPES Registry Identity

NPI1003291535
Entity TypeOrganization
Primary Taxonomy2085R0202X
Legal Business NameRADIOLOGY ASSOCIATES OF TALLAHASSEE PA
Location Address1300 MICCOSUKEE RDTallahassee, FL 32308-5054
Mailing AddressPo Box 1678Tallahassee, FL 32302-1678 · (850) 878-4127
Phone(850) 431-1155
Organization SubpartNo
Authorized OfficialJohn R DetelichCeo · (850) 878-4127
Enumeration DateJuly 27, 2015
✔ NPI 1003291535 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0202X
Definition

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

1300 MICCOSUKEE RD, Tallahassee, FL 32308
Open in Google Maps ↗

Other Identifiers 8

Medicare PIN00060AFL
Medicaid053297505FL
Medicaid300037169AGA
Medicaid053297501FL
Medicaid053297504FL
Medicare PIN00060FL
Other00060FL · Blue Cross Of Florida
OtherCA6404FL · Rr Medicare

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D1100630

Southeast Radiology Partners, Ltd Dba Radiology Associates Of Tallahassee · Tallahassee, FL
Active · expires Jun 8, 2027
CLIA Number10D1100630
Laboratory TypePhysician Office
Certificate Effective DateJune 9, 2025
Certificate Expiration DateJune 8, 2027
Laboratory DirectorMegan Barnes
Laboratory Phone(850) 942-4497
Laboratory LocationSoutheast Radiology Partners, Ltd Dba Radiology Associates Of Tallahassee1600 Phillips Rd, Tallahassee, FL 32308
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PETER ANDREW TURNER PA
Physician Assistant
1300 MICCOSUKEE RD
TALLAHASSEE, FL 32308
Leon County (850) 431-1155
RACHEL FAITH POSTON FNP
Nurse Practitioner
1300 MICCOSUKEE RD
TALLAHASSEE, FL 32308
Leon County (850) 431-1155
ADAM CHONG JOO M.D.
Family Medicine
1300 MICCOSUKEE RD, HOSPITALIST GROUP
TALLAHASSEE, FL 32308
Leon County (850) 431-4996
DR. SHAHRZAD A ZAMANI DO
Student in an Organized Health Care Education/Training Program
1300 MICCOSUKEE RD
TALLAHASSEE, FL 32308
Leon County (850) 431-8261
VARAK ROSDOM MANOOGIAN
Student in an Organized Health Care Education/Training Program
1300 MICCOSUKEE RD
TALLAHASSEE, FL 32308
Leon County (850) 431-8261
BRIAN MENA REYES MD
Student in an Organized Health Care Education/Training Program
1300 MICCOSUKEE RD
TALLAHASSEE, FL 32308
Leon County (850) 431-8261
MS. PAULINE BOHANNON
Speech-Language Pathologist
1300 MICCOSUKEE RD
TALLAHASSEE, FL 32308
Leon County (850) 431-7112
DIANA STONE APRN
Nurse Practitioner (Family)
1300 MICCOSUKEE RD
TALLAHASSEE, FL 32308
Leon County (850) 431-1155

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Radiology Associates Of Tallahassee PA's NPI number?

The NPI number for Radiology Associates Of Tallahassee PA is 1003291535. It was assigned to this organization in the NPPES registry on July 27, 2015.

Where is Radiology Associates Of Tallahassee PA located?

Radiology Associates Of Tallahassee PA is located at 1300 Miccosukee Rd, Tallahassee, FL 32308. The listed phone number is (850) 431-1155.

What is Radiology Associates Of Tallahassee PA's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Does Radiology Associates Of Tallahassee PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D1100630) is associated with this NPI, valid through June 8, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Radiology Associates Of Tallahassee PA was last updated on July 27, 2015. NPI Profile syncs with the weekly NPPES data releases published by CMS.