Provider Demographics
NPI:1275956005
Name:UNIVERSITY OF SOUTH FLORIDA
Entity Type:Organization
Organization Name:UNIVERSITY OF SOUTH FLORIDA
Other - Org Name:SPONSORED RESEARCH
Other - Org Type:Other Name
Authorized Official - Title/Position:ASSOCIATE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-974-6329
Mailing Address - Street 1:3702 SPECTRUM BLVD
Mailing Address - Street 2:SUITE 165
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-9444
Mailing Address - Country:US
Mailing Address - Phone:813-974-2897
Mailing Address - Fax:813-974-4962
Practice Address - Street 1:3702 SPECTRUM BLVD
Practice Address - Street 2:SUITE 165
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-9444
Practice Address - Country:US
Practice Address - Phone:813-974-2897
Practice Address - Fax:813-974-4962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-30
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
No293D00000XLaboratoriesPhysiological Laboratory