West Hernando Diagnostic & Mr Center
Organization Active NPI Diagnostic Radiology Physician · Brooksville, FL
NPI 1013901883 · NPPES record last updated Jul 23, 2021
Key facts
- NPI
- 1013901883
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- Legal business name
- WEST HERNANDO DIAGNOSTIC & MR CENTER
- Practice address
- 15427 Cortez Blvd
Brooksville, FL 34613-6113 - Phone
- (352) 754-0600
- Fax
- (352) 754-0680
- NPI assigned
- Sep 7, 2005
- Organization subpart
- Yes
- Parent organization (as reported)
- WEST HERNANDO DIAGNOSTIC & MR CENTER
Authorized official
- Name
- Ms. Karen Hayes Jr.
- Title
- Cfo
- Phone
- (352) 799-0046
Other NPIs on the same Medicare enrollment 6
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060808000086 | FL | Part B Supplier - Clinic/Group Practice | 4880653195 |
Receives reassigned benefits from 53 practitioners 6 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Hudson, FL; Spring Hill, FL |
National Provider Directory
- Part of
- West Hernando Diagnostic Mr Center
Locations
15427 Cortez Blvd
Brooksville, FL 34613
Phone (352) 754-0600
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician |
2085R0202X | Yes |
Addresses
Primary practice location
15427 Cortez Blvd
Brooksville, FL 34613-6113
Mailing address
15427 Cortez Blvd
Brooksville, FL 34613-6113
Phone (352) 754-0600
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 272166001 | Medicaid | FL |
Other names
- West Hernando Diagnostic Center Brooksville
Other providers in Brooksville, FL
- Mackenzie John Welch
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- West Coast Pathology of Florida PA
- West Coast Surgical Associates
- West Florida Cardiology Network, LLC
- West Shore Endodontics, PLLC
- Yileidy West
- Kimberly S. Westbrook
- Dawn S Wever
- Wheeler Peak Emergency Physicians LLC
All providers in Brooksville, FL · Diagnostic Radiology Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 23, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.