Provider Demographics
NPI:1174520233
Name:NINTEL CORPORATION
Entity type:Organization
Organization Name:NINTEL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:INSURANCE FACILITATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:EMMA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:HALLBACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-676-0043
Mailing Address - Street 1:414 W ROBERTSON ST
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-5010
Mailing Address - Country:US
Mailing Address - Phone:813-676-0043
Mailing Address - Fax:813-676-0053
Practice Address - Street 1:3805 HENDERSON BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33629-5013
Practice Address - Country:US
Practice Address - Phone:813-639-1674
Practice Address - Fax:813-639-1613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL247100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE6747Medicare ID - Type Unspecified