Provider Demographics
NPI:1043427164
Name:OSSATRON SERVICES OF TAMPA BAY II
Entity Type:Organization
Organization Name:OSSATRON SERVICES OF TAMPA BAY II
Other - Org Name:SANUWAVE
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGER, MEDICAL POLICY
Authorized Official - Prefix:
Authorized Official - First Name:PERI
Authorized Official - Middle Name:
Authorized Official - Last Name:KERBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-990-0593
Mailing Address - Street 1:11680 GREAT OAKS WAY
Mailing Address - Street 2:#350
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-2457
Mailing Address - Country:US
Mailing Address - Phone:866-581-6843
Mailing Address - Fax:
Practice Address - Street 1:11680 GREAT OAKS WAY
Practice Address - Street 2:#350
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-2457
Practice Address - Country:US
Practice Address - Phone:866-581-6843
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty