Healthcare Provider Details

I. General information

NPI: 1154781151
Provider Name (Legal Business Name): MANATEE MEMORIAL HOSPITAL LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2016
Last Update Date: 01/24/2022
Certification Date: 01/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

833 N ROBERT AVE
ARCADIA FL
34266-9578
US

IV. Provider business mailing address

833 N ROBERT AVE
ARCADIA FL
34266-9578
US

V. Phone/Fax

Practice location:
  • Phone: 863-491-9970
  • Fax:
Mailing address:
  • Phone: 863-491-9970
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: STEVE FILTON
Title or Position: VICE PRESIDENT
Credential:
Phone: 610-382-3319