Provider Demographics
NPI:1821285388
Name:CARDIOVASCULAR MOBILE ULTRASOUND INC
Entity Type:Organization
Organization Name:CARDIOVASCULAR MOBILE ULTRASOUND INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NUBIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ORJUELA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-417-5888
Mailing Address - Street 1:13904 GLOVER PLACE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-3126
Mailing Address - Country:US
Mailing Address - Phone:813-417-5888
Mailing Address - Fax:813-962-8350
Practice Address - Street 1:13904 GLOVER PLACE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-3126
Practice Address - Country:US
Practice Address - Phone:813-417-5888
Practice Address - Fax:813-962-8350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-28
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLV2964OtherBCBS
U3741OtherMEDICARE PTAN