Provider Demographics
NPI:1164413290
Name:TAAVI MERI
Entity Type:Organization
Organization Name:TAAVI MERI
Other - Org Name:HOME CARE X RAY SVCS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAAVI
Authorized Official - Middle Name:
Authorized Official - Last Name:MERI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-284-7164
Mailing Address - Street 1:PO BOX 4992
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33775-4992
Mailing Address - Country:US
Mailing Address - Phone:941-284-7164
Mailing Address - Fax:877-972-9327
Practice Address - Street 1:12512 MONTARA DR
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33773-2916
Practice Address - Country:US
Practice Address - Phone:941-284-7164
Practice Address - Fax:877-972-9327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-28
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QR0208X
FL18335V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
No261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL030328300Medicaid
FL030328300Medicaid