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General NPI Number Information
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NPI Number | 1386689834
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Entity Type | Organization
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Legal Business Name | LAKEWOOD-MANATEE RADIOLOGY CONSULTANTS
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Dates
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Enumeration Date | 06/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8374 MARKET ST
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City | BRADENTON
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State | FL
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Zip | 34202-5137
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Country | US
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Telephone | 941-955-4101
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Fax | 941-358-9817
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Provider Business Mailing Address
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Address Line | 8340 LAKEWOOD RANCH BLVD
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City | BRADENTON
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State | FL
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Zip | 34202-5183
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Country | US
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Telephone | 941-955-4101
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Fax | 941-358-9817
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | CATHY GRUNEISEN
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Credential |
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Telephone | 941-955-4101
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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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