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Organization

MIDTOWN DIAGNOSTIC LLC

Active
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Organization

MIDTOWN DIAGNOSTIC LLC

Active
Other names
dba Midtown Radiology
Organization subpart
No

Provider details

NPI number
Authorized official
MR. LAVELLE R HARDIN (CREDENTIALING COORDINATOR)
(615) 344-8203
Entity
Organization

Contact information

Practice address
1215 EAST AVENUE SOUTH, STE 207, SARASOTA, FL 34239
(941) 365-5613
(941) 957-1387
Mailing address
1215 EAST AVENUE SOUTH, STE 207, SARASOTA, FL 34239
(941) 365-5613
(941) 957-1387

Taxonomy

Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
—
—
261QR0200X
Radiology Clinic/Center
Primary
—
—
261QR0206X
Mammography Clinic/Center
—
—

Other

Enumeration date
01/31/2007
Last updated
08/16/2007
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