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NPI Code Detail

MEDICARE: MEDICAL IMAGING PROFESSIONALS PA

MEDICARE: MEDICAL IMAGING PROFESSIONALS 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
12085R0202XDiagnostic 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
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1528046745
Entity Type Code : Organization
Provider Name (Legal Business Name) : MEDICAL IMAGING PROFESSIONALS PA
Provider Business Mailing Address
First Line : PO BOX 14457
Second Line :
City : CLEARWATER
State : FL
Zip : 33766-4457
Country : US
Telephone Number : 727-793-9300
Fax Number : 727-712-4688
Provider Business Practice Location Address
First Line : 1000 WATERMAN WAY
Second Line : ATTN: RADIOLOGY DEPT
City : TAVARES
State : FL
Zip : 32778-5266
Country : US
Telephone Number : 352-253-3333
Fax Number : 352-253-3669
Authorized Official
Title or Position : PRESIDENT
Name : FRED S WITTENSTEIN
Credential : MD
Telephone Number : 352-253-3333
Provider Enumeration Date : 01/06/2006
Last Update Date : 03/11/2015

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1073440079 — TAYLOR TAYLOR MSN, APRN, CNM
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1194713289 — MISS WAYNE M NEVALA M.D.
Practice Location Address:
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1700875291 — SARAH E. WALDROP R.N. ,CRNFA
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1750360723 — PAUL R KARLINSKY MD
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Directions to “MEDICAL IMAGING PROFESSIONALS PA ” Practice Location

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