Basic Information
Provider Information
NPI: 1982864542
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HARVEY
FirstName: RYAN
MiddleName: M
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2700 UNIVERSITY SQUARE DR
Address2: RADIOLOGY ASSOC OF TAMPA
City: TAMPA
State: FL
PostalCode: 336125513
CountryCode: US
TelephoneNumber: 8132515822
FaxNumber: 8132544597
Practice Location
Address1: 2700 UNIVERSITY SQUARE DR
Address2: RADIOLOGY ASSOC OF TAMPA
City: TAMPA
State: FL
PostalCode: 336125513
CountryCode: US
TelephoneNumber: 8132515822
FaxNumber: 8132544597
Other Information
ProviderEnumerationDate: 06/16/2008
LastUpdateDate: 03/08/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202XME110577FLY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

No ID Information.


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