Provider Demographics
NPI:1477752319
Name:GPSI LLC
Entity Type:Organization
Organization Name:GPSI LLC
Other - Org Name:GPSI DIGITAL IMAGING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:COLON
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:941-966-7125
Mailing Address - Street 1:258 TAMPA AVE W
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34285-1729
Mailing Address - Country:US
Mailing Address - Phone:941-223-4282
Mailing Address - Fax:941-531-4318
Practice Address - Street 1:258 TAMPA AVE W
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-1729
Practice Address - Country:US
Practice Address - Phone:941-223-4282
Practice Address - Fax:941-531-4318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-11
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC7746261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology