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SIMONMED IMAGING PORT CHARLOTTE
NPI 1811567894
Radiology - Diagnostic Radiology in Port Charlotte, FL

Active since June 30, 2021CLIA 10D2161048 · Waiver
4161 TAMIAMI TRL BLDG 2 UNIT 204, PORT CHARLOTTE, FL 33952(941) 235-3280 Get Directions Write a Review

NPPES record last updated: February 3, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Feb 3, 2022, Jun 30, 2021 (2 updates tracked since 2021).

About Simonmed Imaging Port Charlotte NPPES

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

SIMONMED IMAGING PORT CHARLOTTE (NPI 1811567894) is a healthcare organization registered as a diagnostic radiology in Port Charlotte, Florida and active in the NPI registry since June 2021. The organization holds a CLIA Waiver certificate valid through January 23, 2027 and lists Howard John Simon, Ceo/owner, as its authorized official.

NPPES Registry Identity

NPI1811567894
Entity TypeOrganization
Primary Taxonomy2085R0202X
Legal Business NameSIMONMED IMAGING FLORIDA LLC
Location Address4161 TAMIAMI TRL BLDG 2 UNIT 204Port Charlotte, FL 33952-9204
Mailing Address6900 E Camelback Rd Ste 700Scottsdale, AZ 85251-2400 · (480) 306-6949 · Fax (602) 302-5706
Phone(941) 235-3280
Organization SubpartNo
Authorized OfficialHoward John SimonCeo/owner · (602) 809-6623
Enumeration DateJune 30, 2021
Last NPPES UpdateFebruary 3, 20222 updates tracked since enumeration
NPPES CertifiedFebruary 3, 2022
✔ NPI 1811567894 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.

4161 TAMIAMI TRL BLDG 2 UNIT 204, Port Charlotte, FL 33952
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Other Names 1

Doing Business AsSimonmed Imaging Port Charlotte

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AvMed, Molina Healthcare.Insurance ›

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 10D2161048

Simonmed Imaging Florida LLC Dba Simonmed Imaging Port Charlotte · Port Charlotte, FL
Active · expires Jan 23, 2027
CLIA Number10D2161048
Laboratory TypeOutpatient Medical Imagin
Certificate Effective DateJanuary 24, 2025
Certificate Expiration DateJanuary 23, 2027
Laboratory DirectorVijitha K. Reddy
Laboratory Phone(602) 688-6116
Laboratory LocationSimonmed Imaging Florida LLC Dba Simonmed Imaging Port Charlotte4161 Tamiami Trail Bldg 2 Ste 204, Port Charlotte, FL 33952
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

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 Simonmed Imaging Florida LLC's NPI number?

The NPI number for Simonmed Imaging Florida LLC is 1811567894. It was assigned to this organization in the NPPES registry on June 30, 2021. The provider is doing business as Simonmed Imaging Port Charlotte.

Where is Simonmed Imaging Florida LLC located?

Simonmed Imaging Florida LLC is located at 4161 Tamiami Trl Bldg 2 Unit 204, Port Charlotte, FL 33952. The listed phone number is (941) 235-3280.

What is Simonmed Imaging Florida LLC's specialty?

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

Does Simonmed Imaging Florida LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2161048) is associated with this NPI, valid through January 23, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Simonmed Imaging Florida LLC accept?

Health plans from AvMed and Molina Healthcare list Simonmed Imaging Florida LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Simonmed Imaging Florida LLC was last updated on February 3, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.