Organization
HORIZON THREE LLC
Active
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
520 D ST, STE B, CLEARWATER, FL 33756-3362
(727) 466-9361
(767) 466-0612
Mailing address
240 N WASHINGTON BLVD, SARASOTA, FL 34236-5945
(941) 925-3490
(941) 953-4452
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
HCC5199
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3411968
AETNA HMO PROV NUMBER
—
01
—
5027754
AETNA PPO/POS PROV NUMBER
—
01
—
V2646
BCBS PROVIDER NUMBER
FL
Enumeration date
05/23/2005
Last updated
08/22/2020
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