Manatee Diagnostic Center, LTD
Organization Active NPI Radiology Clinic/Center · Brodenton, FL
NPI 1689760993 · NPPES record last updated Jan 21, 2016
Key facts
- NPI
- 1689760993
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Radiology Clinic/Center 261QR0200X
- Legal business name
- MANATEE DIAGNOSTIC CENTER, LTD
- Practice address
- 300 Riverside Dr E
Suite 4300
Brodenton, FL 34208 - Phone
- (941) 747-3034
- Fax
- (941) 748-5819
- NPI assigned
- Oct 5, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Dowis Graham
- Title
- Executive Director Cfo
- Phone
- (941) 747-3034
Subparts reporting this organization as parent 4
Practitioners 2
-
Angus W Graham, MD
National Provider Directory
Locations
300 Riverside Dr E
Ste 4300
Bradenton, FL 34208
300 Riverside Dr E
Bradenton, FL 34208
Phone (800) 391-2802
250 2nd St E
Ste 4C
Bradenton, FL 34208
Phone (941) 744-5860
2211 60th St W
Bradenton, FL 34209
Phone (813) 536-5537
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiology Clinic/Center | 261QR0200X | Yes |
Addresses
Primary practice location
300 Riverside Dr E
Suite 4300
Brodenton, FL 34208
Mailing address
300 Riverside Dr E
Suite 4300
Brodenton, FL 34208
Phone (941) 747-3034
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 376338200 | Medicaid | FL |
Other providers in Brodenton, FL
All providers in Brodenton, FL · Radiology Clinic/Center in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 21, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.