1316363948 NPI number — TAMPA BAY MRI LLC

Table of content: (NPI 1316363948)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316363948 NPI number — TAMPA BAY MRI LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TAMPA BAY MRI LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1316363948
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/24/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1931 W. MARTIN LUTHER KING BLVD
Provider Second Line Business Mailing Address:
SUITE F
Provider Business Mailing Address City Name:
TAMPA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33607-0000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
813-872-0931
Provider Business Mailing Address Fax Number:
813-872-0022

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1931 W. MARTIN LUTHER KING BLVD
Provider Second Line Business Practice Location Address:
SUITE F
Provider Business Practice Location Address City Name:
TAMPA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33607-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
813-872-0931
Provider Business Practice Location Address Fax Number:
813-872-0022
Provider Enumeration Date:
03/06/2014

Additional Information

Authorized Official

Authorized Official Last Name:
SILVA
Authorized Official First Name:
VICTOR
Authorized Official Middle Name:
AUGUSTO
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
813-872-0931

Provider Taxonomy Codes

  • Taxonomy code: 261QM1200X , with the licence number:  ME79221 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1902146822 . This is a "PRIVATE INSURANCE, PERSONAL INJURY PROTECTION, CASH" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com