Organization
NORTHSIDE IMAGING LLC
Active
Organization
NORTHSIDE IMAGING LLC
Active
Other names
Northside Imaging Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAVELLE HARDIN (CREDENTIALING COORDINATOR)
(615) 344-8203
Entity
Organization
Contact information
Practice address
6006 49TH ST N, STE 140, ST PETERSBURG, FL 33709-2148
(727) 528-5900
(727) 528-5911
Mailing address
6006 49TH ST N, STE 140, ST PETERSBURG, FL 33709-2148
(727) 528-5900
(727) 528-5911
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
10/27/2005
Last updated
08/28/2007
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