MEDICARE: TOWER INTERVENTIONAL ONCOLOGY AND VASCULAR CENTER INC

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
2	2085R0204X	Vascular & Interventional Radiology Physician

General Provider Information

NPI Number	:	1871720060
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOWER INTERVENTIONAL ONCOLOGY AND VASCULAR CENTER INC

Provider Business Mailing Address
First Line	:	2700 UNIVERSITY SQUARE DR
Second Line	:	TOWER INTERVENTIONAL ONCOLOGY AND VASCULAR CENTER INC
City	:	TAMPA
State	:	FL
Zip	:	33612-5513
Country	:	US
Telephone Number	:	813-251-5822
Fax Number	:	813-253-2299

Provider Business Practice Location Address
First Line	:	3069 GRAND PAVILION DR
Second Line	:	TOWER INTERVENTIONAL ONCOLOGY AND VASCULAR CENTER INC
City	:	TAMPA
State	:	FL
Zip	:	33613-3757
Country	:	US
Telephone Number	:	813-387-1354
Fax Number	:	813-879-1809

Authorized Official
Title or Position	:	CEO
Name	:	LARRY SMITH
Credential	:
Telephone Number	:	813-251-5822

Provider Enumeration Date	:	06/16/2009
Last Update Date	:	06/16/2009

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