Organization
MIDTOWN DIAGNOSTIC LLC
Active
Other names
dba Midtown Radiology
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAVELLE R HARDIN (CREDENTIALING COORDINATOR)
(615) 344-8203
Entity
Organization
Contact information
Practice address
1215 EAST AVENUE SOUTH, STE 101, SARASOTA, FL 34239
(941) 365-4565
(941) 955-3284
Mailing address
1215 EAST AVENUE SOUTH, STE 101, SARASOTA, FL 34239
(941) 365-4565
(941) 955-3284
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
—
—
261QR0200X
Radiology Clinic/Center
Primary
—
—
261QR0206X
Mammography Clinic/Center
—
—
Other
Enumeration date
01/31/2007
Last updated
08/16/2007
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