Healthcare Provider Details

I. General information

NPI: 1578544615
Provider Name (Legal Business Name): MRI ASSOCIATES OF TAMPA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2005
Last Update Date: 06/22/2021
Certification Date: 06/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6800 N DALE MABRY HWY SUITE 144
TAMPA FL
33614-3997
US

IV. Provider business mailing address

6800 N DALE MABRY HWY SUITE 144
TAMPA FL
33614-3997
US

V. Phone/Fax

Practice location:
  • Phone: 813-886-9999
  • Fax: 813-885-2800
Mailing address:
  • Phone: 813-886-9999
  • Fax: 813-885-2800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2471C3402X
TaxonomyRadiography Radiologic Technologist
License NumberHCC3804
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN W STEVENS
Title or Position: PRESIDENT
Credential:
Phone: 813-886-9999