Organization
SAPPHIRE BRANDON LTD
Active
Other names
Brandon Open MRI
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY STONE (PRESIDENT AND CEO)
(813) 205-0312
Entity
Organization
Contact information
Practice address
615 VONDERBURG DR, BRANDON, FL 33511-5972
(813) 657-5579
(813) 675-6130
Mailing address
615 VONDERBURG DR, BRANDON, FL 33511-5972
(813) 205-0312
(813) 657-6130
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
HCC4890
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
030708400
—
FL
Enumeration date
12/28/2005
Last updated
09/16/2011
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