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Organization
SUN CITY IMAGING LLC
Active
Organization
SUN CITY IMAGING LLC
Active
Other names
Total Imaging of Sun City
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAVELLE HARDIN (CREDENTIALING COORDINATOR)
(615) 344-8203
Entity
Organization
Contact information
Practice address
3862 SUN CITY CENTER BLVD, SUN CITY, FL 33573
(813) 657-7575
(813) 684-3040
Mailing address
3862 SUN CITY CENTER BLVD, SUN CITY, FL 33573
(813) 657-7575
(813) 684-3040
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
—
—
261QR0200X
Radiology Clinic/Center
Primary
—
—
261QR0206X
Mammography Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00277443
RR MEDICARE
FL
Enumeration date
06/21/2005
Last updated
03/18/2008
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