Organization
MRI ASSOCIATES OF BRANDON, LLC
Active
Other names
Brandon MRI
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA MAPLE (CAO)
(727) 787-6900
Entity
Organization
Contact information
Practice address
403 S KINGS AVE STE 200R, BRANDON, FL 33511-5905
(813) 210-8995
(813) 409-2914
Mailing address
403 S KINGS AVE, BRANDON, FL 33511-5905
(813) 210-8995
(813) 409-2914
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
—
—
261Q00000X
Clinic/Center
—
—
261QR0200X
Radiology Clinic/Center
Primary
HCC10828
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019700100
—
FL
01
—
W07M
BCBS
FL
Enumeration date
08/22/2016
Last updated
05/07/2025
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