Organization
DIS OF TAMPA BAY INC
Active
Other names
New Vista Diagnostic of Fountain Oaks
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LESSY RODRIGUEZ (ADMINISTRATOR)
(813) 724-3310
Entity
Organization
Contact information
Practice address
3635 W WATERS AVE, TAMPA, FL 33614-2783
(813) 408-9161
Mailing address
3635 W WATERS AVE, TAMPA, FL 33614-2783
(813) 724-3310
(813) 280-4923
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Enumeration date
08/12/2019
Last updated
01/30/2020
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