Organization
BRADEN RIVER INTERNAL MEDICINE ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTINE T LOMBOY MD (OWNER)
(941) 329-1329
Entity
Organization
Contact information
Practice address
8625 54TH DR E, BRADENTON, FL 34211-9456
(941) 238-0380
(941) 238-0390
Mailing address
PO BOX 405484, ATLANTA, GA 30384-5484
(941) 238-0380
(941) 238-0390
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME86360
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
62800
BCBS OF FL
FL
Enumeration date
08/25/2008
Last updated
05/24/2010
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