Organization
MEDFUND LLC
Active
Other names
horizon two 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
6220 MANATEE AVE W, STE 101, BRADENTON, FL 34209-2303
(941) 761-8594
(941) 761-3815
Mailing address
240 N WASHINGTON BLVD, SARASOTA, FL 34236-5945
(941) 925-3490
(951) 953-4452
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
HCC5210
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3411979
AETNA HMO PROVIDER NUMBER
—
01
—
5079697
AETNA PPO/POS PROV NUMBER
—
01
—
V2645
BCBS PROVIDER NUMBER
FL
Enumeration date
05/23/2005
Last updated
08/22/2020
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