SIMONMED IMAGING FLORIDA LLC NPI 1477830818

NPI Information

NPI: 1477830818
Provider Name: SIMONMED IMAGING FLORIDA LLC

Doing Business As: SIMONMED IMAGING TAMPA

Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

Address:
14302 BRUCE B DOWNS BLVD
TAMPA, FL
ZIP 33613
Phone: (813) 979-7580
Get Directions

SIMONMED IMAGING FLORIDA LLC is a diagnostic radiology radiology in Tampa, FL. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. SIMONMED IMAGING FLORIDA LLC NPI is 1477830818. The provider is registered as an organization entity type.
The provider Is Doing Business As Simonmed Imaging Tampa.

The provider's business location address is:

14302 BRUCE B DOWNS BLVD
TAMPA, FL
ZIP 33613-601
Phone: (813) 979-7580

The provider's authorized official is Howard John Simon .
The authorized official title is Ceo/owner and has the following contact phone number (602) 809-6623.

The CLIA number assigned to this NPI record is 10D2137048 - other - outpatient med imag with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/14/2011 and was last updated on 8/3/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0207X	Clinic/Center	Radiology, Mobile Mammography			No
2	2085R0202X	Radiology	Diagnostic Radiology		FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	004602901	MEDICAID	FLORIDA
2	FW240	OTHER	FLORIDA	SIMONMED IMAGING OCOEE II
3	FW240A	OTHER	FLORIDA	SIMONMED IMAGING SUN CITY
4	004602906	MEDICAID	FLORIDA
5	004602909	MEDICAID	FLORIDA
6	004602910	MEDICAID	FLORIDA
7	FW240	OTHER	FLORIDA	SIMONMED IMAGING POINCIANA
8	FW240	OTHER	FLORIDA	SIMONMED IMAGING LAKE MARY II
9	FW240	OTHER	FLORIDA	SIMONMED IMAGING LONGWOOD
10	FW240	OTHER	FLORIDA	SIMONMED IMAGING CLERMONT
11	004602902	MEDICAID	FLORIDA
12	004602905	MEDICAID	FLORIDA
13	004602907	MEDICAID	FLORIDA
14	004602908	MEDICAID	FLORIDA
15	DS5839	OTHER	FLORIDA	RAILROAD MEDICARE
16	FW240	OTHER	FLORIDA	SIMONMED IMAGING TAMPA
17	004602903	MEDICAID	FLORIDA
18	004602904	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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