Organization
HIGHLANDS BREAST & IMAGING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK A. CARRUTHERS M.D. (PRESIDENT)
(863) 385-6655
Entity
Organization
Contact information
Practice address
115 MEDICAL CENTER AVE, SEBRING, FL 33870-5423
(863) 385-6655
(863) 385-2282
Mailing address
PO BOX 144333, ORLANDO, FL 32814-4333
(407) 422-9831
(407) 648-2065
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CB4926
RAILROAD MEDICARE
—
01
—
V3136
BLUE CROSS BLUE SHIELD OF FLORIDA
FL
Enumeration date
11/11/2005
Last updated
05/29/2008
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