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NPI Code Detail

MEDICARE: MEDFUND LLC

MEDICARE: MEDFUND LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM1200XMagnetic Resonance Imaging (MRI) Clinic/CenterHCC5184FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1V2651OTHERFLBCBS PROVIDER #
2105715-20OTHERFLCITRUS HMO

General Provider Information

NPI Number : 1033112149
Entity Type Code : Organization
Provider Name (Legal Business Name) : MEDFUND LLC
Provider Business Mailing Address
First Line : 240 N WASHINGTON BLVD
Second Line :
City : SARASOTA
State : FL
Zip : 34236-5945
Country : US
Telephone Number : 941-925-3490
Fax Number : 941-953-4452
Provider Business Practice Location Address
First Line : 1117 N OLIVE AVE
Second Line : STE 101
City : WEST PALM BEACH
State : FL
Zip : 33401-3520
Country : US
Telephone Number : 561-651-7410
Fax Number : 561-651-7417
Authorized Official
Title or Position : SENIOR VICE PRESIDENT
Name : MR. MARTIN J KERN
Credential :
Telephone Number : 941-925-3490
Provider Enumeration Date : 05/23/2005
Last Update Date : 08/22/2020

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Directions to “MEDFUND LLC ” Practice Location

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