Organization
NORTH TAMPA IMAGING LLC
Active
Organization
NORTH TAMPA IMAGING LLC
Active
Other names
dba NTIC (New Tampa Imaging Center)
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAVELLE HARDIN (CREDENTIALING & ENROLLMENT)
(615) 344-8203
Entity
Organization
Contact information
Practice address
14302 BRUCE B DOWNS BLVD, TAMPA, FL 33613-2601
(813) 975-1111
(813) 975-0555
Mailing address
14302 BRUCE B DOWNS BLVD, TAMPA, FL 33613-2601
(813) 975-1111
(813) 975-0555
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
272080900
—
FL
01
—
P00273453
RR MEDICARE
FL
01
—
V3026
BCBS OF FL
FL
Enumeration date
10/26/2006
Last updated
04/17/2009
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