Provider Demographics
NPI:1710051487
Name:ULTRASOUND IMAGING SPECIALISTS, INC.
Entity Type:Organization
Organization Name:ULTRASOUND IMAGING SPECIALISTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:J
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-461-0613
Mailing Address - Street 1:PO BOX 14307
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33766-4307
Mailing Address - Country:US
Mailing Address - Phone:727-461-0613
Mailing Address - Fax:727-461-0713
Practice Address - Street 1:1860 COUNTY ROAD 193
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33759-1801
Practice Address - Country:US
Practice Address - Phone:727-461-0613
Practice Address - Fax:727-461-0713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC6316335V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========Medicare UPIN
FLE3427Medicare ID - Type Unspecified