Provider Demographics
NPI:1922180009
Name:SOUTH TAMPA IMAGING ASSOCIATES PA
Entity Type:Organization
Organization Name:SOUTH TAMPA IMAGING ASSOCIATES PA
Other - Org Name:BERNARD D. STEIN, MD.,PA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:W
Authorized Official - Last Name:KNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-342-1440
Mailing Address - Street 1:PO BOX 3156
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46206-3156
Mailing Address - Country:US
Mailing Address - Phone:855-870-6780
Mailing Address - Fax:855-277-8545
Practice Address - Street 1:2901 SWANN AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-4056
Practice Address - Country:US
Practice Address - Phone:813-342-1440
Practice Address - Fax:813-872-5695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2015-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCN1631OtherRR MEDICARE
98277OtherBC BS OF FLORIDA
FL370400900Medicaid
FL370400900Medicaid