MEDICARE: AFFORDABLE PORTABLE ULTRASOUND LLP

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	335V00000X	Portable X-ray and/or Other Portable Diagnostic Imaging Supplier

General Provider Information

NPI Number	:	1265065924
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AFFORDABLE PORTABLE ULTRASOUND LLP

Provider Business Mailing Address
First Line	:	1211 TECH BLVD STE 114
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33619-7846
Country	:	US
Telephone Number	:	813-549-7820
Fax Number	:	813-549-7823

Provider Business Practice Location Address
First Line	:	1211 TECH BLVD STE 114
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33619-7846
Country	:	US
Telephone Number	:	813-549-7820
Fax Number	:	813-549-7823

Authorized Official
Title or Position	:	DIRECTOR OF BUSINESS OPERATIONS
Name	:	DR. DONNIE LANE
Credential	:	PHARMD
Telephone Number	:	813-549-7820

Provider Enumeration Date	:	02/20/2020
Last Update Date	:	02/20/2020

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