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General NPI Number Information
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NPI Number | 1104198258
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Entity Type | Organization
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Legal Business Name | BOWES IMAGING CENTER, LLC
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Dates
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Enumeration Date | 02/06/2012
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Last Update Date | 04/11/2013
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Provider Practice Location Address
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Address Line | 3900 CLARK RD SUITE P
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City | SARASOTA
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State | FL
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Zip | 34233-2301
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Country | US
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Telephone | 941-924-8600
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Fax | 941-924-2300
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Provider Business Mailing Address
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Address Line | 3900 CLARK RD SUITE P
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City | SARASOTA
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State | FL
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Zip | 34233-2301
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Country | US
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Telephone | 941-924-4860
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Fax | 941-924-2300
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | MR. NATHAN BOWES
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Credential |
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Telephone | 941-924-8600
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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 | HCC 9548
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License Number State | FL
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