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General NPI Number Information
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NPI Number | 1013950401
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Entity Type | Organization
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Legal Business Name | BON-BONE MEDICAL IMAGING, INC.
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Dates
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Enumeration Date | 06/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6499 38TH AVE N SUITE G2
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City | ST PETERSBURG
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State | FL
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Zip | 33710-1656
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Country | US
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Telephone | 727-341-2866
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Fax | 727-341-2876
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Provider Business Mailing Address
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Address Line | 7040 SEMINOLE PRATT WHITNEY RD STE. 25-166
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City | LOXAHATCHEE
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State | FL
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Zip | 33470-2468
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Country | US
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Telephone | 800-664-2663
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Fax | 561-792-5199
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MRS. KAREN HARDY
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Credential |
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Telephone | 561-753-8557
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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