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Organization

NORTH BRANDON IMAGING LLC

Active
Other names
Tower Diagnostic Center of Brandon
Organization subpart
No

Provider details

NPI number
Authorized official
MR. WILLIAM B. RUTHERFORD (SENIOR VP)
(615) 309-2190
Entity
Organization

Contact information

Practice address
613 OAKFIELD DRIVE, BRADON, FL 33511
(813) 661-2222
(813) 681-8494
Mailing address
613 OAKFIELD DR, BRANDON, FL 33511-5714
(813) 661-2222
(813) 681-8494

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
272079500
FL
01
P00280433
RR MEDICARE
FL
01
V3028
BCBS OF FL
FL
Enumeration date
10/13/2006
Last updated
08/30/2011
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