| NPI | 1104106582 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLIS B. NORSOPH President/CEO 813-899-6220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology |
| Additional Taxonomies | 261QR0200X Clinic/Center Radiology |
| 2085R0204X Radiology Vascular & Interventional Radiology | |
| 2085B0100X Radiology Body Imaging | |
| 2085N0700X Radiology Neuroradiology | |
| Enumeration Date | 2011-08-17 |
| Last Update Date | 2015-03-25 |