Active NPI
MRI Associates of Brandon, LLC
Doing business as Brandon MRI
- Radiology Clinic/Center
- Brandon, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiology Clinic/Center
- License
- HCC10828
- Legal business name
- MRI ASSOCIATES OF BRANDON, LLC
- Doing business as
- Brandon MRI
- Practice address
- 403 S Kings Ave Ste 200R
Brandon, FL 33511-5905 - Phone
- (813) 210-8995
- Fax
- (813) 409-2914
- NPI assigned
- Aug 22, 2016
- Last updated
- May 7, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Amanda Maple
- Title
- Cao
- Phone
- (727) 787-6900
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | |||
| Radiology Clinic/Center | 261QR0200X | HCC10828 | FL | Primary |
| Diagnostic Radiology Physician | 2085R0202X |
Addresses
Primary practice location
403 S Kings Ave Ste 200R
Brandon, FL 33511-5905
Mailing address
403 S Kings Ave
Brandon, FL 33511-5905
Phone (813) 210-8995
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| W07M | Other | FL | BCBS |
| 019700100 | Medicaid | FL |
Other names 1
- Brandon MRI
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170322001126 | FL | Part B Supplier - Independent Diagnostic Testing Facility (Idtf) | 5890070486 | Practice locations: Brandon, FL |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D2123655 | MRI Associates of Brandon LLC | Certificate of waiver | Dec 27, 2026 |
National Provider Directory
National Provider DirectoryLocations
403 S Kings Ave
Brandon, FL 33511
403 S Kings Ave
Ste 200
Brandon, FL 33511
Phone (813) 210-8995
403 S Kings Ave
Ste 200R
Brandon, FL 33511
Phone (813) 210-8995
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Vascular & Interventional Radiology Physician
- Tarpon Springs, FL
- NPI 1376511576
-
- Diagnostic Radiology Physician
- Leesburg, FL
- NPI 1073504650
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471824000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1746576000000",
"number": "1578018305",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "403 S KINGS AVE",
"city": "BRANDON",
"state": "FL",
"postal_code": "335115905",
"telephone_number": "813-210-8995",
"fax_number": "813-409-2914"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "403 S KINGS AVE STE 200R",
"city": "BRANDON",
"state": "FL",
"postal_code": "335115905",
"telephone_number": "813-210-8995",
"fax_number": "813-409-2914"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MRI ASSOCIATES OF BRANDON, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2016-08-22",
"last_updated": "2025-05-07",
"certification_date": "2025-05-07",
"status": "A",
"authorized_official_last_name": "MAPLE",
"authorized_official_first_name": "AMANDA",
"authorized_official_title_or_position": "CAO",
"authorized_official_telephone_number": "727-787-6900"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QR0200X",
"taxonomy_group": "",
"desc": "Clinic/Center, Radiology",
"state": "FL",
"license": "HCC10828",
"primary": true
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "W07M",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "019700100",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Brandon MRI",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Brandon, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.