Healthcare Provider Details

I. General information

NPI: 1104149236
Provider Name (Legal Business Name): PARTNER'S IMAGING CENTER OF EAST SARASOTA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2010
Last Update Date: 09/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N CATTLEMEN RD SUITE 100
SARASOTA FL
34232-6422
US

IV. Provider business mailing address

1250 S TAMIAMI TRL SUITE 103
SARASOTA FL
34239-2221
US

V. Phone/Fax

Practice location:
  • Phone: 941-894-3332
  • Fax: 941-894-3123
Mailing address:
  • Phone: 941-951-2100
  • Fax: 941-894-3123

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. RICHARD M. GOLDBERG
Title or Position: MANAGING PARTNER
Credential:
Phone: 941-951-2100