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Organization
SHARPER IMAGING DIAGNOSTIC RADIOLOGY CENTER INC
Active
Organization
SHARPER IMAGING DIAGNOSTIC RADIOLOGY CENTER INC
Active
Other names
Harbor Imaging
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY BLACKMER (BUSINESS OFFICE MANAGER)
(941) 276-3517
Entity
Organization
Contact information
Practice address
3430 TAMIAMI TRL, SUITE B, PORT CHARLOTTE, FL 33952-8127
(941) 883-8383
(941) 883-8386
Mailing address
3430 TAMIAMI TRL, SUITE B, PORT CHARLOTTE, FL 33952-8127
(941) 883-8383
(941) 883-8386
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
ME67871
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
150492200863
HUMANA
—
01
—
213119
AMERIGROUP
—
01
—
V2822
BCBS
—
Enumeration date
09/21/2006
Last updated
08/22/2020
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