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Organization
SRA VENTURES INC
Active
Organization
SRA VENTURES INC
Active
Other names
WESTCOAST RADIOLOGY
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTHONY ABOUD D.O. (C.E.O.)
(727) 835-1450
Entity
Organization
Contact information
Practice address
2040 SHORT AVE, #103, ODESSA, FL 33556-3445
(727) 835-1450
(727) 835-1470
Mailing address
501 S LINCOLN AVE, #15, CLEARWATER, FL 33756-5945
(727) 446-6760
(727) 441-2465
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E4187
MEDICARE PTAN
FL
Enumeration date
10/01/2009
Last updated
04/08/2010
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