Provider Demographics
NPI:1851527139
Name:SUNCOAST MRI, INC.
Entity Type:Organization
Organization Name:SUNCOAST MRI, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILHELM
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-569-0794
Mailing Address - Street 1:3010 E 138TH AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-3902
Mailing Address - Country:US
Mailing Address - Phone:813-569-0794
Mailing Address - Fax:813-333-7358
Practice Address - Street 1:3010 E 138TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-3902
Practice Address - Country:US
Practice Address - Phone:813-569-0794
Practice Address - Fax:813-333-7358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-01
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM1200X, 261QR0200X, 261QR0206X
FLHCC8591261QM1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
No261QR0206XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mammography