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Organization

BON-BONE MEDICAL IMAGING, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. KAREN HARDY (BILLING MANAGER)
(561) 753-8557
Entity
Organization

Contact information

Practice address
6499 38TH AVE N, SUITE G2, ST PETERSBURG, FL 33710-1656
(727) 341-2866
(727) 341-2876
Mailing address
7040 SEMINOLE PRATT WHITNEY RD, STE. 25-166, LOXAHATCHEE, FL 33470-2468
(800) 664-2663
(561) 792-5199

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
102686
AVMED
DC
01
137014
PREFERRED CARE
FL
01
2243421
AETNA
FL
01
2243431
AETNA
FL
01
2243437
AETNA
FL
01
2592718
GHI
DC
01
579259
AETNA
FL
01
7723768
AETNA
FL
01
V1173
BC/BS
FL
01
V1267
BC/BS
FL
01
V1761
BC/BS
FL
01
V1836
BC/BS
FL
Enumeration date
06/13/2006
Last updated
08/22/2020
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