1427499250 NPI number — TRIUMPH RADIOLOGY ASSOCIATES PA

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427499250 NPI number — TRIUMPH RADIOLOGY ASSOCIATES PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TRIUMPH RADIOLOGY ASSOCIATES PA
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:
1427499250
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6843 N CITRUS AVE
Provider Second Line Business Mailing Address:
BLDG 3 SUITE K
Provider Business Mailing Address City Name:
CRYSTAL RIVER
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34428-6933
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
352-795-5628
Provider Business Mailing Address Fax Number:
352-795-9262

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3233 SW 33RD RD STE 301
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OCALA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34474-8425
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
352-554-4878
Provider Business Practice Location Address Fax Number:
352-795-9262
Provider Enumeration Date:
07/09/2013

Additional Information

Authorized Official

Authorized Official Last Name:
WILKES
Authorized Official First Name:
MELISSA
Authorized Official Middle Name:
D
Authorized Official Title or Position:
BILLING MANAGER
Authorized Official Telephone Number:
352-795-5628

Provider Taxonomy Codes

  • Taxonomy code: 261QR0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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