Organization
ULTRA IMAGING OF TAMPA LLC
Active
Other names
dba Ultra Imaging of St. Petersburg
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAVELLE HARDIN (CREDENTIALING COORDINATOR)
(615) 344-8203
Entity
Organization
Contact information
Practice address
6449 38TH AVE N, SUITE B-3, ST PETERSBURG, FL 33710-1655
(727) 381-1674
(727) 381-4226
Mailing address
6449 38TH AVE N, SUITE B-3, ST PETERSBURG, FL 33710-1655
(727) 381-1674
(727) 381-4226
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
10/31/2005
Last updated
08/02/2007
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