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Florida: ACTIVE DIAGNOSTIC IMAGING LLC TAMPA FL 33609-1516 813-348-0049

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ACTIVE DIAGNOSTIC IMAGING LLC

Technologists, Technicians & Other Technical Service Providers Radiologic Technologist Vascular Sonography

Provider NPI: 1700056009

Organization Information:
Organization Name:  ACTIVE DIAGNOSTIC IMAGING LLC
Organization is not Subpart
Authorized Official:  JESSICA  VILLEGAS  PRESIDENT  813-348-0049

Practice Location:
3110 W GRAY ST  TAMPA, FL 33609-1516 US
Tel: 813-348-0049  Fax: --

Business Mailing Address:
PO BOX 320905  TAMPA, FL 33679-2905 US
Tel: 813-348-0049  Fax: --

NPI Information:
NPI: 1700056009
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N2471V0105XTechnologists, Technicians & Other Technical Service Providers
Radiologic Technologist
Vascular Sonography
FLL08000017078
Y2471S1302XTechnologists, Technicians & Other Technical Service Providers
Radiologic Technologist
FLL08000017078

Other Provider Identifiers:

IssuerNumberStateType