Healthcare Provider Details

I. General information

NPI: 1831183607
Provider Name (Legal Business Name): WEST HERNANDO DIAGNOSTIC AND M.R. CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2005
Last Update Date: 07/23/2021
Certification Date: 07/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3315 COMMERCIAL WAY
SPRING HILL FL
34606-2699
US

IV. Provider business mailing address

3315 COMMERCIAL WAY
SPRING HILL FL
34606-2699
US

V. Phone/Fax

Practice location:
  • Phone: 352-688-5860
  • Fax: 352-688-4347
Mailing address:
  • Phone: 352-688-5860
  • Fax: 352-688-4347

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. KAREN HAYES JR.
Title or Position: CFO
Credential:
Phone: 352-799-0046