SRA VENTURES INC (NPI# 1295069672) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295069672 |
| Entity Type | Organization |
| Organization Name | SRA VENTURES INC |
| Other Organization Name | WESTCOAST RADIOLOGY |
| Practice Address |
2040 Short Ave #103 Odessa FL 33556-3445 |
| Mailing Address |
501 S Lincoln Ave #15 Clearwater FL 33756-5945 |
| Practice Telephone | 7278351450 |
| Practice Fax Number | 7278351470 |
| Mailing Telephone | 7274466760 |
| Mailing Fax Number | 7274412465 |
| Enumeration Date | 2009-10-01 |
| Last Update Date | 2010-04-08 |
| Authorized Official Name | DR. ANTHONY ABOUD (C.E.O.) |
| Authorized Official Telephone | 7278351450 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0200X |
Clinic/Center Specialization: Radiology |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | MEDICARE PTAN | E4187 | 01 |
| Other Name | Type Code |
|---|---|
| WESTCOAST RADIOLOGY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548366941 | Sra Ventures Inc | Clinic/Center | 10125 W. Colonial Drive, Ste# 116-118, Ocoee, FL 34761 | 2006-09-15 |
| 1477560514 | Sra Ventures Inc | Clinic/Center | 1193 Blackwood Ave, Unit H, Ocoee, FL 34761-4518 | 2006-08-02 |
| 1508873647 | Sra Ventures Inc | Clinic/Center | 36463 Us Highway 19 N, Palm Harbor, FL 34684-1329 | 2006-08-02 |
| 1205829934 | Sra Ventures Inc | Clinic/Center | 501 S Lincoln Ave, #15, Clearwater, FL 33756-5945 | 2005-08-29 |
| 1760799258 | Sra Ventures Inc | Clinic/Center | 3451 66th St N, St Petersburg, FL 33710-1568 | 2010-09-07 |
| Street Address |
2040 SHORT AVE #103 |
| City | ODESSA |
| State | FL |
| Zip Code | 33556-3445 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831164870 | James Billys | Orthopaedic Surgery | 2040 Short Ave, Odessa, FL 33556-3445 | 2006-02-22 |
| 1942675764 | Jacob Choi | Family Medicine | 2040 Short Ave, Odessa, FL 33556-3445 | 2015-12-04 |
| 1750752291 | Farhan Siddiqi, Md Pa | Orthopaedic Surgery | 2040 Short Ave, Suite 100, Odessa, FL 33556-3445 | 2015-10-09 |
| 1790075562 | Nathan A Possert | Physical Therapist | 2040 Short Ave, Odessa, FL 33556-3445 | 2011-04-14 |
| 1962661116 | Johannes Helmert Wijnmaalen | Physical Therapist | 2040 Short Ave, Odessa, FL 33556-3445 | 2008-06-03 |
| 1407025430 | Kamaldeen Rizvie Saldin | Psychiatry & Neurology | 2040 Short Ave, Odessa, FL 33556-3445 | 2008-02-24 |
| 1114100195 | Melissa D Erb | Nurse Practitioner | 2040 Short Ave, Odessa, FL 33556-3445 | 2007-12-12 |
| 1124220108 | Suzanne E Stacey | Dietitian, Registered | 2040 Short Ave, Suite 100, Odessa, FL 33556-3445 | 2007-06-03 |
| 1487743563 | Spine and Orthopaedic Specialists, Pllc | Orthopaedic Surgery | 2040 Short Ave, Odessa, FL 33556-3427 | 2006-10-12 |
| 1457379661 | Naveed A Siddiqi | Internal Medicine | 2040 Short Ave, Odessa, FL 33556-3445 | 2006-07-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538773890 | Asc of Trinity | Clinic/Center | 15238 Virginia Station, Odessa, FL 33556 | 2020-09-03 |
| 1700409240 | All In One Dme LLC | Durable Medical Equipment & Medical Supplies | 17086 Simms Road, Odessa, FL 33556 | 2020-05-19 |
| 1578123287 | Publix Super Markets, Inc. | Durable Medical Equipment & Medical Supplies | 13589 State Road 54, Odessa, FL 33556 | 2019-06-14 |
| 1790244267 | Gabriela Fernandez Strickland | Psychologist | 16117 Lytham Drive, Odessa, FL 33556 | 2019-03-14 |
| 1699288266 | Melissa Knight | Pharmacist | 12515 Hitching St, Odessa, FL 33556 | 2017-11-06 |
| 1144604109 | Maria Litak | Pharmacist | 12500 State Road 54, Odessa, FL 33556 | 2015-07-19 |
| 1366671927 | Manik S Bedi | Dentist | 17751 Gunn Hwy, Odessa, FL 33556 | 2009-07-03 |
| 1043295090 | Kathleen Young Harrell | Nurse Practitioner | 17121 Rainbow Terrace, Odessa, FL 33556 | 2005-12-13 |
| 1558854281 | Thianna Marie Diamandis | Assistant Behavior Analyst | 16414 Lake Church Dr, Odessa, FL 33556 | 2018-06-07 |
| 1508384124 | Lacie Gunter | Behavior Technician | 16414 Lake Church Dr, Odessa, FL 33556 | 2017-09-04 |
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| Taxonomy Code | 261QR0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology |
| Definition to come... |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.