MEDICARE: MEDFUND LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM1200X	Magnetic Resonance Imaging (MRI) Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0410DC	OTHER	TX	BCBS PROV
2	268489	OTHER		AMERIGROUP
3	7416610	OTHER		AETNA/MEDSOLUTIONS

General Provider Information

NPI Number	:	1174526966
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDFUND LLC

Provider Business Mailing Address
First Line	:	240 N WASHINGTON BLVD
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34236-5945
Country	:	US
Telephone Number	:	941-925-3490
Fax Number	:	941-953-4452

Provider Business Practice Location Address
First Line	:	6550 N MACARTHUR BLVD
Second Line	:	STE 120
City	:	IRVING
State	:	TX
Zip	:	75039-2823
Country	:	US
Telephone Number	:	972-444-0100
Fax Number	:	972-444-0282

Authorized Official
Title or Position	:	SENIOR VICE PRESIDENT
Name	:	MARTIN J KERN
Credential	:
Telephone Number	:	941-925-3490

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	08/22/2020

Similar Medicare Providers

1285678490 — CENTRAL LINE INFUSION DALLAS DIVISION LTD
Practice Location Address:

8080 TRISTAR DRIVE , SUITE 120
IRVING, TX
75063-2823

Practice Phone: 972-815-0460
Practice Fax: 972-915-3841

1558847152 — ADRIANE POWELL
Practice Location Address:

8080 TRISTAR DR STE 120
IRVING, TX
75063-2823

Practice Phone: 972-815-0460
Practice Fax:

1699638312 — DIANESHA RAY
Practice Location Address:

400 EAST ROYAL LANE , BUILDING 3, SUITE 290
IRVING, TX
75039

Practice Phone: 504-442-3616
Practice Fax:

1538023809 — KEYARA GREEN
Practice Location Address:

400 E ROYAL LN STE 290
IRVING, TX
75039-3602

Practice Phone: 855-832-6727
Practice Fax:

1467927749 — ARIANE ANTIONETTE MADISON
Practice Location Address:

400 E ROYAL LN STE 290
IRVING, TX
75039-3602

Practice Phone: 855-832-6727
Practice Fax: 772-675-9100

1447113535 — JESSICA LYNN BROWN
Practice Location Address:

400 E ROYAL LN STE 290
IRVING, TX
75039-3602

Practice Phone: 855-832-6727
Practice Fax:

Directions to “MEDFUND LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.