Organization
AMERIMED DIAGNOSTIC SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GUIDOVER MANSO (PRESIDENT)
(813) 307-0933
Entity
Organization
Contact information
Practice address
500 W MARTIN LUTHER KING BLVD, TAMPA, FL 33603-3402
(813) 307-0933
(813) 307-0657
Mailing address
500 W MARTIN LUTHER KING BLVD, TAMPA, FL 33603-3402
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MM21087
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HCC3985
AHCA
FL
Enumeration date
08/12/2009
Last updated
08/12/2009
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