1841298361 NPI number — TRANSFLORIDA MOBILE DIAGNOSTIC SERVICES LC

Table of content: (NPI 1841298361)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841298361 NPI number — TRANSFLORIDA MOBILE DIAGNOSTIC SERVICES LC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TRANSFLORIDA MOBILE DIAGNOSTIC SERVICES LC
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:
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:
1841298361
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/26/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
805 S ORLANDO AVE
Provider Second Line Business Mailing Address:
SUITE F
Provider Business Mailing Address City Name:
WINTER PARK
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32789-4869
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
888-929-2224
Provider Business Mailing Address Fax Number:
877-972-9327

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
805 S ORLANDO AVE
Provider Second Line Business Practice Location Address:
SUITE F
Provider Business Practice Location Address City Name:
WINTER PARK
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32789-4869
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-929-2224
Provider Business Practice Location Address Fax Number:
877-972-9327
Provider Enumeration Date:
07/08/2005

Additional Information

Authorized Official

Authorized Official Last Name:
PYLES
Authorized Official First Name:
DONALD
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
888-929-2224

Provider Taxonomy Codes

  • Taxonomy code: 293D00000X , with the licence number:  HCC3857 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 335V00000X , with the licence number: HCC3857 , 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: 630001602 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 510018600 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00237663 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 105409 . This is a "WELLCARE HMO" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 16-00698 . This is a "EVERCARE HMO" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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