Provider Demographics
NPI:1679823231
Name:EXCELLERAD
Entity type:Organization
Organization Name:EXCELLERAD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROB
Authorized Official - Middle Name:
Authorized Official - Last Name:ARTURI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-440-1809
Mailing Address - Street 1:5137 S LAKELAND DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-2595
Mailing Address - Country:US
Mailing Address - Phone:863-397-9875
Mailing Address - Fax:863-937-8966
Practice Address - Street 1:5137 S LAKELAND DR
Practice Address - Street 2:SUITE 1
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-2595
Practice Address - Country:US
Practice Address - Phone:863-397-9875
Practice Address - Fax:863-937-8966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-11
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service