Organization
NISOS HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONNIE GUHA (MANAGER)
(347) 304-9286
Entity
Organization
Contact information
Practice address
7901 4TH ST N STE 300, ST PETERSBURG, FL 33702-4399
(844) 900-2523
Mailing address
7901 4TH ST N STE 300, ST PETERSBURG, FL 33702-4399
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
261QR0200X
Radiology Clinic/Center
—
—
261QR0208X
Mobile Radiology Clinic/Center
—
—
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
—
—
Other
Enumeration date
04/29/2021
Last updated
07/01/2021
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