Organization
ADVANTAGE OPEN MRI OF TAMPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY MARK SMITH (PRESIDENT OWNER)
(727) 939-2674
Entity
Organization
Contact information
Practice address
3104 W WATERS AVE, #14, TAMPA, FL 33634
(813) 935-5332
(813) 933-5849
Mailing address
101 E KENNEDY BLVD, SUITE 2350, TAMPA, FL 33602-5179
(813) 463-4441
(813) 849-6349
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
8176
FL
261QR0200X
Radiology Clinic/Center
HCC6139
FL
Other
Enumeration date
07/05/2006
Last updated
07/16/2008
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