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General NPI Number Information
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NPI Number | 1881689487
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Entity Type | Individual
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Provider Name | MARK J. RIEUMONT M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/20/2005
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Last Update Date | 04/11/2025
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Provider Practice Location Address
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Address Line | 1 TAMPA GENERAL CIRCLE RADIOLOGY DEPARTMENT
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City | TAMPA
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State | FL
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Zip | 33606
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Country | US
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Telephone | 813-253-2721
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Fax | 813-977-3720
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Provider Business Mailing Address
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Address Line | 2330 UTAH AVE STE 200
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City | EL SEGUNDO
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State | CA
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Zip | 90245-4817
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Country | US
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Telephone | 424-290-8004
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Fax | 813-253-2299
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 75363
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 75363
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | ME74591
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | ME74591
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License Number State | FL
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