Organization
MANATEE DIAGNOSTIC CENTER WEST
Active
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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