Healthcare Provider Details

I. General information

NPI: 1003180530
Provider Name (Legal Business Name): NORTH TAMPA RADIOLOGY CONSULTANTS, PL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2012
Last Update Date: 03/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9441 HEALTH CENTER DR
LAND O LAKES FL
34637-5837
US

IV. Provider business mailing address

PO BOX 23057
TAMPA FL
33623-2057
US

V. Phone/Fax

Practice location:
  • Phone: 813-903-3700
  • Fax: 813-985-8006
Mailing address:
  • Phone: 813-899-6220
  • Fax: 813-985-8006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ELLIS B NORSOPH
Title or Position: PRESIDENT
Credential: M.D,
Phone: 813-899-6223