Provider Demographics
NPI:1386004901
Name:PRECISION MEDICAL IMAGING AND THERAPEUTIC INSTITUTE LLC
Entity Type:Organization
Organization Name:PRECISION MEDICAL IMAGING AND THERAPEUTIC INSTITUTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:OKOH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-920-5200
Mailing Address - Street 1:2540 GREEN FOREST LN
Mailing Address - Street 2:SUITE #101
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33558-5388
Mailing Address - Country:US
Mailing Address - Phone:813-920-5200
Mailing Address - Fax:
Practice Address - Street 1:2540 GREEN FOREST LN
Practice Address - Street 2:SUITE #101
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33558-5388
Practice Address - Country:US
Practice Address - Phone:813-920-5200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-24
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty