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General NPI Number Information
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NPI Number | 1033432166
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Entity Type | Organization
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Legal Business Name | PARTNERS IMAGING CENTER OF BRADENTON
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Dates
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Enumeration Date | 03/03/2010
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Last Update Date | 09/13/2011
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Provider Practice Location Address
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Address Line | 5101 4TH AVENUE CIR E SUITE 100
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City | BRADENTON
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State | FL
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Zip | 34208-5630
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Country | US
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Telephone | 941-782-0414
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Fax | 941-782-0418
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Provider Business Mailing Address
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Address Line | 1250 S TAMIAMI TRL SUITE 103
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City | SARASOTA
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State | FL
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Zip | 34239-2221
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Country | US
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Telephone | 941-951-2100
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Fax | 941-894-3123
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | DR. RICHARD M. GOLDBERG
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Credential | MD
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Telephone | 941-951-2100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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