# LAKEWOOD RANCH IMAGING CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104839737
- **Authorized official:** MS. DIANE BYNUM (DIRECTOR)
- **Authorized official phone:** (941) 782-3050

## Contact information

- **Practice address:** 8330 LAKEWOOD RANCH BLVD, BRADENTON, FL 34202-5174
- **Practice address phone:** (941) 782-3050
- **Mailing address:** PO BOX 409956, ATLANTA, GA 30384-9956
- **Mailing address phone:** (941) 782-3050

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2085B0100X | Body Imaging Physician | — | NULL | Yes |
| 2085B0100X | Body Imaging Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/14/2006
- **Last updated:** 08/17/2007