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NPI Code Detail

MEDICARE: PASCO RADIOLOGY CONSULTANTS

MEDICARE: PASCO RADIOLOGY CONSULTANTS
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
1261QR0200XRadiology Clinic/Center

General Provider Information

NPI Number : 1457401127
Entity Type Code : Organization
Provider Name (Legal Business Name) : PASCO RADIOLOGY CONSULTANTS
Provider Business Mailing Address
First Line : PO BOX 20627
Second Line :
City : TAMPA
State : FL
Zip : 33622-0627
Country : US
Telephone Number : 813-899-6226
Fax Number : 813-985-8006
Provider Business Practice Location Address
First Line : 5637 MARINE PKWY
Second Line :
City : NEW PORT RICHEY
State : FL
Zip : 34652-4316
Country : US
Telephone Number : 727-848-1733
Fax Number : 813-985-8006
Authorized Official
Title or Position : PRESIDENT
Name : DR. ELLIS B. NORSOPH
Credential : M.D.
Telephone Number : 813-899-6220
Provider Enumeration Date : 01/12/2007
Last Update Date : 08/22/2020

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