Organization
ULTRA IMAGING OF TAMPA LLC
Active
Other names
Ultra Imaging of Mid-Pinellas
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAVELLE R HARDIN (CREDENTIALING COORDINATOR)
(615) 344-8203
Entity
Organization
Contact information
Practice address
13787 BELCHER RD S, SUITE 300, LARGO, FL 33771-4065
(727) 497-1674
(727) 497-4674
Mailing address
13787 BELCHER RD S, STE 300, LARGO, FL 33771-4065
(813) 657-4914
(813) 657-4916
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
—
—
261QR0200X
Radiology Clinic/Center
Primary
—
—
261QR0206X
Mammography Clinic/Center
—
—
Other
Enumeration date
07/07/2005
Last updated
08/02/2007
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