Organization
PINELLAS NEUROINTERVENTIONAL CONSULTANTS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ELLIS B. NORSOPH MD (PRESIDENT/CEO)
(813) 899-6220
Entity
Organization
Contact information
Practice address
701 6TH STREET SOUTH, ST PETERSBURG, FL 33701-4814
(727) 823-1234
(813) 985-8006
Mailing address
PO BOX 23057, TAMPA, FL 33623-3057
(813) 899-6220
(813) 985-8006
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010458400
—
FL
Enumeration date
01/06/2014
Last updated
03/25/2015
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