Midtown Diagnostic LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

MIDTOWN DIAGNOSTIC LLC

Doing business as

dba Midtown Radiology

Practice address

1215 East Avenue South
Ste 105
Sarasota, FL 34239

Phone

(941) 954-4030

Fax

(941) 955-3282

NPI assigned

Jan 31, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Lavelle R Hardin

Title

Credentialing Coordinator

Phone

(615) 344-8203

Specialties & licenses 3

Addresses

Other names 1

• dba Midtown Radiology Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187222400000",
    "number": "1124165998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 EAST AVENUE SOUTH",
            "address_2": "STE 105",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "34239",
            "telephone_number": "941-954-4030",
            "fax_number": "941-955-3282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 EAST AVENUE SOUTH",
            "address_2": "STE 105",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "34239",
            "telephone_number": "941-954-4030",
            "fax_number": "941-955-3282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDTOWN DIAGNOSTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2007-08-16",
        "status": "A",
        "authorized_official_last_name": "HARDIN",
        "authorized_official_first_name": "LAVELLE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "615-344-8203",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0206X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mammography",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "dba Midtown Radiology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Annie Lee Mickelson, D.C.
• Connie D Micklavzina, MD
• Scott A Middleton, DMD, MD
• Midnight Pass Chiropractic
• Midtown Diagnostic LLC
• Midtown Diagnostic LLC
• Midtown Diagnostic LLC
• Midtown Diagnostics LLC
• Midtown Diagnostics LLC
• Midtown Diagnostics LLC

• Radiology Clinic/Center in Sarasota, FL
• Providers in Sarasota, FL by specialty
• Radiology Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.