Healthcare Provider Details

I. General information

NPI: 1568422996
Provider Name (Legal Business Name): MRI ASSOCIATES OF PALM HARBOR, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2006
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32615 US HIGHWAY 19 N SUITE 4
PALM HARBOR FL
34684-3176
US

IV. Provider business mailing address

32615 US HIGHWAY 19 N SUITE 4
PALM HARBOR FL
34684-3176
US

V. Phone/Fax

Practice location:
  • Phone: 727-787-6900
  • Fax: 727-216-4789
Mailing address:
  • Phone: 727-787-6900
  • Fax: 727-787-2754

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License NumberHCC3787
License Number StateFL

VIII. Authorized Official

Name: AMANDA MAPLE
Title or Position: CHIEF ADMINISTRATIVE OFFICER
Credential:
Phone: 727-787-6900