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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