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Organization
TWO RIVERS DIAGNOSTIC CENTER INC
Active
Organization
TWO RIVERS DIAGNOSTIC CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BARBARA SIMON (VICE PRESIDENT)
(941) 827-0051
Entity
Organization
Contact information
Practice address
2810 MANATEE AVE E, BRADENTON, FL 34208-1828
(941) 827-0051
(941) 827-0057
Mailing address
2810 MANATEE AVE E, BRADENTON, FL 34208-1828
(941) 827-0051
(941) 827-0057
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
HCC6008
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7572667
AETNA PROVIDER NUMBER
FL
01
—
V2926
BCBS PROVIDER NUMBER
FL
Enumeration date
07/10/2006
Last updated
01/03/2008
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