MEDICARE: RADIOLOGY ASSOCIATES OF TAMPA PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician

General Provider Information

NPI Number	:	1245672583
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RADIOLOGY ASSOCIATES OF TAMPA PA

Provider Business Mailing Address
First Line	:	2700 UNIVERSITY SQUARE DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33612-5513
Country	:	US
Telephone Number	:	813-253-2721
Fax Number	:	813-253-2299

Provider Business Practice Location Address
First Line	:	787 CORTARO DR
Second Line	:	JSA SUN CITY CENTER
City	:	RUSKIN
State	:	FL
Zip	:	33573-6812
Country	:	US
Telephone Number	:	813-634-2500
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. LARRY T SMITH
Credential	:
Telephone Number	:	813-253-2721

Provider Enumeration Date	:	07/29/2013
Last Update Date	:	08/27/2013

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