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NPI Code Detail

MEDICARE: PASCO IMAGING CONSULTANTS, PL

MEDICARE: PASCO IMAGING CONSULTANTS, PL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QR0200XRadiology Clinic/Center4400FL
22085R0204XVascular & Interventional Radiology Physician
32085B0100XBody Imaging Physician
42085N0700XNeuroradiology Physician
52085R0202XDiagnostic Radiology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
24400OTHERFLSTATE LICENSE #

General Provider Information

NPI Number : 1184768533
Entity Type Code : Organization
Provider Name (Legal Business Name) : PASCO IMAGING CONSULTANTS, PL
Provider Business Mailing Address
First Line : PO BOX 20627
Second Line :
City : TAMPA
State : FL
Zip : 33622-0627
Country : US
Telephone Number : 813-899-6226
Fax Number : 813-985-8006
Provider Business Practice Location Address
First Line : 5637 MARINE PARKWAY
Second Line :
City : NEW PORT RICHEY
State : FL
Zip : 34652-4316
Country : US
Telephone Number : 727-848-1733
Fax Number : 813-985-8006
Authorized Official
Title or Position : PRESIDENT/CEO
Name : MR. ELLIS B. NORSOPH
Credential : MD
Telephone Number : 813-899-6220
Provider Enumeration Date : 02/19/2007
Last Update Date : 03/25/2015

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