NPIMap

Organization Active NPI

Maru Diagnostic Imaging Services PA

  • Diagnostic Radiology Physician
  • Tampa, FL
National Provider Identifier
1083973655
Registry record updated May 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME 107580 Issued in FL
Legal business name
MARU DIAGNOSTIC IMAGING SERVICES PA
Practice address
4325 Henderson Blvd
Tampa, FL 33629-5612
Phone
(813) 639-1674
Fax
(813) 639-1613
NPI assigned
May 16, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Ashley Brian Maru, M.D.
Title
President
Phone
(813) 639-1674

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X ME 107580 FL Primary

Addresses

Primary practice location

4325 Henderson Blvd
Tampa, FL 33629-5612

Mailing address

4325 Henderson Blvd
Tampa, FL 33629-5612
Phone (813) 639-1674

National Provider Directory

National Provider Directory

Locations

414 W Robertson St
Ste 102
Brandon, FL 33511
Phone (813) 657-6767

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1337126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337126400000",
    "number": "1083973655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4325 HENDERSON BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336295612",
            "telephone_number": "813-639-1674",
            "fax_number": "813-639-1613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4325 HENDERSON BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336295612",
            "telephone_number": "813-639-1674",
            "fax_number": "813-639-1613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARU DIAGNOSTIC IMAGING SERVICES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-16",
        "last_updated": "2012-05-16",
        "status": "A",
        "authorized_official_last_name": "MARU",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_middle_name": "BRIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-639-1674",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME 107580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.