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NPI Code Detail

MEDICARE: RADIOLOGY ASSOCIATES OF TAMPA PA

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
12085N0700XNeuroradiology Physician
22085N0904XNuclear Radiology Physician
32085P0229XPediatric Radiology Physician
42085R0202XDiagnostic Radiology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1477720837
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 : RAT AT KINDRED HOSP BAY AREA ST PETERSBURG
City : TAMPA
State : FL
Zip : 33612-5513
Country : US
Telephone Number : 813-251-5822
Fax Number :
Provider Business Practice Location Address
First Line : 3030 6TH ST S
Second Line : RADIOLOGY ASSOC OF TAMPA AT KINDRED HOSPITAL BAY AREASP
City : ST PETERSBURG
State : FL
Zip : 33705-3720
Country : US
Telephone Number : 727-894-8719
Fax Number :
Authorized Official
Title or Position : CEO
Name : MR. LARRY SMITH
Credential :
Telephone Number : 813-251-5822
Provider Enumeration Date : 05/14/2008
Last Update Date : 08/27/2009

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