Provider Demographics
NPI:1093112831
Name:MEDICAL ARTS COMPREHENSIVE DIAGNOSTIC SERVICES INC
Entity Type:Organization
Organization Name:MEDICAL ARTS COMPREHENSIVE DIAGNOSTIC SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILHELM
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-569-0794
Mailing Address - Street 1:3010 EAT 138TH AVE SUITE 100
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-3999
Mailing Address - Country:US
Mailing Address - Phone:813-569-0794
Mailing Address - Fax:813-333-7358
Practice Address - Street 1:3010 E 138TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-3902
Practice Address - Country:US
Practice Address - Phone:813-569-0794
Practice Address - Fax:813-333-7358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-21
Last Update Date:2014-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty