Organization
SHARPER IMAGING DIAGNOSTIC RADIOLOGY CENTER INC
Active
Other names
Harbor Imaging
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY BLACKMER (BUSINESS OFFICE MANAGER)
(941) 276-3517
Entity
Organization
Contact information
Practice address
3430 TAMIAMI TRL, SUITE B, PORT CHARLOTTE, FL 33952-8127
(941) 883-8383
(941) 883-8386
Mailing address
3430 TAMIAMI TRL, SUITE B, PORT CHARLOTTE, FL 33952-8127
(941) 883-8383
(941) 883-8386
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
ME67871
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
150492200863
HUMANA
—
01
—
213119
AMERIGROUP
—
01
—
V2822
BCBS
—
Enumeration date
09/21/2006
Last updated
08/22/2020
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