MEDICARE: ADVANCED IMAGING & WELLNESS 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	261Q00000X	Clinic/Center
2	261QR0200X	Radiology Clinic/Center

General Provider Information

NPI Number	:	1255286175
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED IMAGING & WELLNESS LLC

Provider Business Mailing Address
First Line	:	2677 S TAMIAMI TRL STE 5
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34239-4500
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2677 S TAMIAMI TRL STE 5
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34239-4500
Country	:	US
Telephone Number	:	941-280-5054
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KEN BRAND
Credential	:
Telephone Number	:	941-356-2797

Provider Enumeration Date	:	03/04/2026
Last Update Date	:	03/04/2026

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