1184005985 NPI number — CLINICAL RESEARCH TRIALS OF FLORIDA, INC.

Table of content: (NPI 1184005985)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184005985 NPI number — CLINICAL RESEARCH TRIALS OF FLORIDA, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CLINICAL RESEARCH TRIALS OF FLORIDA, INC.
Provider Last Name:
Provider First Name:
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Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
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Provider Other Last Name:
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NPI Number Information

NPI Number:
1184005985
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/17/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2713 W VIRGINIA AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TAMPA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33607-6327
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
813-873-8102
Provider Business Mailing Address Fax Number:
813-873-8104

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2713 W VIRGINIA AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TAMPA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33607-6327
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
813-873-8102
Provider Business Practice Location Address Fax Number:
813-873-8104
Provider Enumeration Date:
06/17/2015

Additional Information

Authorized Official

Authorized Official Last Name:
ALPIZAR
Authorized Official First Name:
SADY
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
813-873-8102

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X , with the licence number:  ME106415 , 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)





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