Tricoh Diagnostics

Primary specialty

Other Specialist/TechnologistTaxonomy code 246Z00000X

License

ME78386 Issued in FL

Legal business name

TRICOH DIAGNOSTICS

Practice address

12004 Race Track Rd
Tampa, FL 33626-3109

Phone

(813) 902-2640

Fax

(813) 814-4080

NPI assigned

Oct 13, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Todd Allen Blackwood

Title

Owner

Phone

(813) 753-8598

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1413158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413504000000",
    "number": "1376947838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12004 RACE TRACK RD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336263109",
            "telephone_number": "813-902-2640",
            "fax_number": "813-814-4080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12004 RACE TRACK RD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336263109",
            "telephone_number": "813-902-2640",
            "fax_number": "813-814-4080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRICOH DIAGNOSTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-13",
        "last_updated": "2014-10-17",
        "status": "A",
        "authorized_official_last_name": "BLACKWOOD",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-753-8598",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "246Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Other",
            "state": "FL",
            "license": "ME78386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Other Specialist/Technologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2014; 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.