Organization Active NPI

MRI Associates of Brandon, LLC

Doing business as Brandon MRI

  • Radiology Clinic/Center
  • Brandon, FL
National Provider Identifier
1578018305
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
License
HCC10828 Issued in FL
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, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2025

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
W07MOtherFLBCBS
019700100MedicaidFL

Other names 1

  • Brandon MRI Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170322001126 FL Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 5890070486 Practice locations: Brandon, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2123655MRI Associates of Brandon LLC403 S Kings Ave, Brandon, FL 33511Certificate of waiverDec 27, 2026

National Provider Directory

National Provider Directory

Locations

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 NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

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.

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.

Verify at the official NPI Registry.