Organization
MANATEE DIAGNOSTIC CENTER WEST
Active
Parent organization
MANATEE DIAGNOSTIC CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
MANATEE DIAGNOSTIC CENTER
Authorized official
DAVIS W GRAHAM (EXECUTIVE DIRECTOR)
(941) 747-3034
Entity
Organization
Contact information
Practice address
2211 60TH ST WEST, BRADENTON, FL 34209
(941) 747-3034
Mailing address
2211 60TH ST WEST, BRADENTON, FL 34209
(941) 747-3034
(941) 748-5819
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
ME6540
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
48245500
—
FL
Enumeration date
12/27/2011
Last updated
12/27/2011
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