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Organization
UNIVERSITY DIAGNOSTIC INSTITUTE LTD
Active
Organization
UNIVERSITY DIAGNOSTIC INSTITUTE LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PAMELA EDWARDS MBA (DIRECTOR OF OPERATIONS)
(813) 972-3351
Entity
Organization
Contact information
Practice address
3301 ALUMNI DR, TAMPA, FL 33612-9413
(813) 972-3351
(913) 971-6892
Mailing address
3301 ALUMNI DR, TAMPA, FL 33612-9413
(813) 972-3351
(913) 971-6892
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
—
—
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
—
—
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06060900
—
FL
01
—
081944
AVMED
FL
01
—
227379
AMERIGROUP
FL
01
—
V2338
BLUE CROSS BLUE SHIELD
FL
Enumeration date
11/23/2005
Last updated
09/27/2007
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