Provider Demographics
NPI:1316363948
Name:TAMPA BAY MRI LLC
Entity Type:Organization
Organization Name:TAMPA BAY MRI LLC
Other - Org Name:VICTOR A. SILVA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:AUGUSTO
Authorized Official - Last Name:SILVA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-872-0931
Mailing Address - Street 1:1931 W. MARTIN LUTHER KING BLVD
Mailing Address - Street 2:SUITE F
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-0000
Mailing Address - Country:US
Mailing Address - Phone:813-872-0931
Mailing Address - Fax:813-872-0022
Practice Address - Street 1:1931 W. MARTIN LUTHER KING BLVD
Practice Address - Street 2:SUITE F
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-0000
Practice Address - Country:US
Practice Address - Phone:813-872-0931
Practice Address - Fax:813-872-0022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-06
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79221261QM1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1902146822OtherPRIVATE INSURANCE, PERSONAL INJURY PROTECTION, CASH