Provider Demographics
NPI:1790066975
Name:TOWER IMAGING LLC
Entity Type:Organization
Organization Name:TOWER IMAGING LLC
Other - Org Name:TGH IMAGING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF REVENUE CYCLE MGMT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-261-2400
Mailing Address - Street 1:2700 UNIVERSITY SQUARE DR
Mailing Address - Street 2:TOWER IMAGING INC
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-5513
Mailing Address - Country:US
Mailing Address - Phone:813-251-5822
Mailing Address - Fax:
Practice Address - Street 1:500 VONDERBURG DR
Practice Address - Street 2:SUITE 111
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5964
Practice Address - Country:US
Practice Address - Phone:813-654-5400
Practice Address - Fax:813-436-2882
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOWER IMAGING LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-09-01
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC65512085B0100X, 2085D0003X, 2085N0700X, 2085P0229X, 2085R0202X, 2085U0001X, 261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody ImagingGroup - Multi-Specialty
No2085D0003XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic NeuroimagingGroup - Multi-Specialty
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiologyGroup - Multi-Specialty
No2085P0229XAllopathic & Osteopathic PhysiciansRadiologyPediatric RadiologyGroup - Multi-Specialty
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Multi-Specialty
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL00169Medicare PIN