NPI |
1053599514 |
|
Entity Type Code |
2 |
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual
human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO). |
Employer Identification Number EIN |
|
The last name of the provider. If the provider is an individual, this is the legal name. |
Provider Organization Name Legal Business Name |
TRO INC |
The first name of the provider, if the provider
is an individual. |
Provider First Line Business Practice Location Address |
6798 CROSSWINDS DR N |
The middle name of the provider, if the provider
is an individual. |
Provider Second Line Business Practice Location Address |
C101 |
The name prefix or salutation of the provider
if the provider is an individual; for example, Mr., Mrs., or Corporal. |
Provider Business Practice Location Address City Name |
ST PETERSBURG |
The abbreviations for professional degrees or credentials used or held by the provider,
if the provider is an individual. Examples
are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations
will not be verified by NPS. |
Provider Business Practice Location Address State Name |
FL |
The first line location address of the provider
being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box. |
Provider Business Practice Location Address Postal Code |
337105477 |
The city name in the location address of the provider being identified. |
Provider Business Practice Location Address Country Code If outside U S |
US |
The State code in the location of the provider
being identified. |
Provider Business Practice Location Address Telephone Number |
7273441830 |
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. |
Provider Enumeration Date |
2/7/2008 |
The country code in the location address of the provider being identified. |
Last Update Date |
3/31/2008 |
The telephone number associated with the location address of the provider being identified. |
Authorized Official Last Name |
OERTEL |
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider. |
Authorized Official First Name |
THOMAS |
The first name of the authorized official. |
Authorized Official Middle Name |
ROBERT |
The code designating the provider’s gender if the provider is a person. |
Authorized Official Title or Position |
PRESIDENT |
Code designating the provider type, classification,
and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1. |
Authorized Official Telephone Number |
7273441830 |
The 10-position telephone number of the authorized official. |
Healthcare Provider Taxonomy Code 1 |
335E00000X |
Code designating the provider type, classification,
and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1. |
Healthcare Provider Primary Taxonomy Switch 1 |
Y |
Code designating the provider type, classification,
and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1. |
Is Organization Subpart |
N |
|