NPIMap

Organization Active NPI

St Joseph's Diagnostic Center,LTD

Doing business as Carrollwood

  • Specialist
  • Tampa, FL
National Provider Identifier
1821061144
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
ST JOSEPH'S DIAGNOSTIC CENTER,LTD
Doing business as
Carrollwood
Practice address
14310 N Dale Mabry Hwy
Tampa, FL 33618-2059
Phone
(813) 960-2808
Fax
(813) 852-3233
NPI assigned
Feb 8, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Tommy Inzina
Title
Exec VP
Phone
(727) 820-8004

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

14310 N Dale Mabry Hwy
Tampa, FL 33618-2059

Mailing address

P O Box 403800
Atlanta, GA 30384-0001
Phone (813) 852-3272

Other identifiers 1

IdentifierTypeStateIssuer
061048800MedicaidFL

Other names 1

  • Carrollwood Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Baycare Outpatient Imaging6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

14310 N Dale Mabry Hwy
Tampa, FL 33618
Phone (813) 960-2808

NPI Registry JSON

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1821061144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 403800",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303840001",
            "telephone_number": "813-852-3272",
            "fax_number": "813-852-3233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14310 N DALE MABRY HWY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336182059",
            "telephone_number": "813-960-2808",
            "fax_number": "813-852-3233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JOSEPH'S DIAGNOSTIC CENTER,LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "INZINA",
        "authorized_official_first_name": "TOMMY",
        "authorized_official_title_or_position": "EXEC VP",
        "authorized_official_telephone_number": "727-820-8004"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "061048800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carrollwood",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 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.