Provider Demographics
NPI:1629355805
Name:TITAN MEDICAL OF FLORDIA
Entity Type:Organization
Organization Name:TITAN MEDICAL OF FLORDIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TATE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-309-8449
Mailing Address - Street 1:301 W PLATT ST
Mailing Address - Street 2:SUITE 390
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-2292
Mailing Address - Country:US
Mailing Address - Phone:404-309-8449
Mailing Address - Fax:678-284-6500
Practice Address - Street 1:301 W PLATT ST
Practice Address - Street 2:SUITE 390
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-2292
Practice Address - Country:US
Practice Address - Phone:404-309-8449
Practice Address - Fax:678-284-6500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-15
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies