Organization
MEDFUND LLC
Active
Other names
Horizon Orlando One LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARTIN J KERN (SENIOR VICE PRESIDENT)
(941) 925-3490
Entity
Organization
Contact information
Practice address
500 N SEMORAN BLVD, STE 103, ORLANDO, FL 32807-3381
(407) 275-6072
(407) 275-7301
Mailing address
240 N WASHINGTON BLVD, SARASOTA, FL 34236-5945
(941) 925-3490
(941) 953-4452
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
HCC5217
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
105715-04
CITRUS HMO
FL
01
—
V2399
BCBS PROVIDER #
FL
Enumeration date
05/27/2005
Last updated
08/22/2020
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