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General NPI Number Information
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NPI Number | 1689621476
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Entity Type | Organization
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Legal Business Name | ADVANTAGE OPEN MRI
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Dates
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Enumeration Date | 05/28/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1200 S PINELLAS AVE #14
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City | TARPON SPRINGS
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State | FL
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Zip | 34689
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Country | US
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Telephone | 727-939-2674
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Fax | 727-939-2000
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Provider Business Mailing Address
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Address Line | 1200 S PINELLAS AVE #14
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City | TARPON SPRINGS
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State | FL
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Zip | 34689
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Country | US
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Telephone | 727-939-2674
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Fax | 727-939-2000
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Authorized Official
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Title or Position | PRESIDENT & OWNER
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Name | GARY MARK SMITH
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Credential |
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Telephone | 727-939-2674
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
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License Number | 9979
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | HCC5730
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License Number State |
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