Organization
MEDICAL IMAGING PROFESSIONALS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FRED S WITTENSTEIN MD (PRESIDENT)
(352) 253-3333
Entity
Organization
Contact information
Practice address
1000 WATERMAN WAY, ATTN: RADIOLOGY DEPT, TAVARES, FL 32778-5266
(352) 253-3333
(352) 253-3669
Mailing address
PO BOX 14457, CLEARWATER, FL 33766-4457
(727) 793-9300
(727) 712-4688
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
269797100
—
FL
05
—
269797102
—
FL
Enumeration date
01/06/2006
Last updated
03/11/2015
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