Provider Demographics
NPI:1194379743
Name:TOWER IMAGING LLC
Entity Type:Organization
Organization Name:TOWER IMAGING LLC
Other - Org Name:TGH IMAGING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF REVENUE CYCLE MGMT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-261-2400
Mailing Address - Street 1:2700 UNIVERSITY SQUARE DRIVE
Mailing Address - Street 2:TOWER IMAGING INC
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-5513
Mailing Address - Country:US
Mailing Address - Phone:813-253-2721
Mailing Address - Fax:813-253-2299
Practice Address - Street 1:2115 LITTLE RD
Practice Address - Street 2:
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-4410
Practice Address - Country:US
Practice Address - Phone:727-847-5122
Practice Address - Fax:727-846-8549
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOWER IMAGING LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-07-31
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL043166420Medicaid