Maverick Medical Ventures, Inc.

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

License

HCC5056 Issued in FL

Legal business name

MAVERICK MEDICAL VENTURES, INC.

Doing business as

Physicians Choice MRI & Imaging

Practice address

3501 Cattlemen Rd
Suite C
Sarasota, FL 34232-6055

Phone

(941) 342-7667

Fax

(941) 342-7847

NPI assigned

Oct 25, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Daniel F Bafia

Title

President

Phone

(941) 342-7667

Specialties & licenses 1

Addresses

Other identifiers 8

Other names 1

• Physicians Choice MRI & Imaging Doing business as

Locations

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1548345234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 CATTLEMEN RD",
            "address_2": "SUITE C",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342326055",
            "telephone_number": "941-342-7667",
            "fax_number": "941-342-7847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 CATTLEMEN RD",
            "address_2": "SUITE C",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342326055",
            "telephone_number": "941-342-7667",
            "fax_number": "941-342-7847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAVERICK MEDICAL VENTURES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BAFIA",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "941-342-7667",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "FL",
            "license": "HCC5056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCN PROVIDER NUMBER",
            "identifier": "5425850",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE COMPLETE",
            "identifier": "82030",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD PROVIDER",
            "identifier": "A2545060",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "V2973",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER NUMBER",
            "identifier": "7180294",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP PROVIDER NUMBE",
            "identifier": "226521",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH PROVIDER NUM",
            "identifier": "2013853",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STAYWELL PROVIDER",
            "identifier": "201694",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Physicians Choice MRI & Imaging",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Genevieve Alexandria Robi Matthews
• Siedah Sasha Matthews
• Alyssa Monique Mattison, PHARMD
• Lauren Nicole Mauck, M.A, L.M.F.T.
• Noel A. Maun, MD, PHD
• Amanda Louise Mavor, APRN, AGACNP-BC
• Panajota Mavrakis
• Maxfield Imaging LLC
• Maxhealth Now of Florida, LLC
• Maxider Corporation (Peak Physical Therapy)

• Radiology Clinic/Center in Sarasota, FL
• Providers in Sarasota, FL by specialty
• Radiology Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.