Healthcare Provider Details

I. General information

NPI: 1588690010
Provider Name (Legal Business Name): PETER A HREHOROVICH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14055 RIVEREDGE DR STE 250
TAMPA FL
33637-2141
US

IV. Provider business mailing address

14055 RIVEREDGE DR STE 250
TAMPA FL
33637-2141
US

V. Phone/Fax

Practice location:
  • Phone: 813-929-5451
  • Fax:
Mailing address:
  • Phone: 813-929-5451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License NumberME 93284
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME93284
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License NumberME 93284
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License NumberME 93284
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: