1770545121 NPI number — MRI ASSOCIATES OF SPRING HILL, INC

Table of content: (NPI 1770545121)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770545121 NPI number — MRI ASSOCIATES OF SPRING HILL, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MRI ASSOCIATES OF SPRING HILL, INC
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:
1770545121
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/27/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6451 TOUCAN TRL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPRING HILL
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34607-2642
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
352-684-2811
Provider Business Mailing Address Fax Number:
352-684-0212

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6451 TOUCAN TRL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPRING HILL
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34607-2642
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
352-684-2811
Provider Business Practice Location Address Fax Number:
352-684-0212
Provider Enumeration Date:
04/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WEINHAUER
Authorized Official First Name:
MICHELLE
Authorized Official Middle Name:
M
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
352-684-2811

Provider Taxonomy Codes

  • Taxonomy code: 261QR0200X , with the licence number:  HCC3801 , 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: 3400300 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 77743389 . This is a "AETNA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: V2323 . This is a "BCBS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 000000001288 . This is a "OPTIMUM" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 305955 . This is a "AVMED" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 209428 . This is a "WELLCARE/STAYWELL" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 9537761 . This is a "CIGNA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com