Organization
TRICOH DIAGNOSTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TODD ALLEN BLACKWOOD (OWNER)
(813) 753-8598
Entity
Organization
Contact information
Practice address
12004 RACE TRACK RD, TAMPA, FL 33626-3109
(813) 902-2640
(813) 814-4080
Mailing address
12004 RACE TRACK RD, TAMPA, FL 33626-3109
(813) 902-2640
(813) 814-4080
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
ME78386
FL
Other
Enumeration date
10/13/2014
Last updated
10/17/2014
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