South Brandon Imaging LLC

NPI #1124028824 in Brandon, Florida

Provider Information

NPI Number
1124028824
Entity Type
Organization
Organization Name
South Brandon Imaging LLC
Primary Specialty
Clinic/Center - Radiology
Enumeration Date
Jul 26, 2005
Last Updated
Mar 18, 2008

Practice Location

Address
737 W BRANDON BLVD
State
Florida
ZIP Code
33511-4901
Phone
(813) 657-7575

Authorized Official

Name
MR. LAVELLE HARDIN
Title
CREDENTIALING COORDINATOR
Phone
(615) 344-8203

Specialties & Taxonomy Codes

Specialty
Clinic/Center - Magnetic Resonance Imaging (MRI)Magnetic Resonance Imaging (MRI)
Clinic/Center - Radiology, MammographyRadiology, Mammography
Clinic/Center - RadiologyRadiology

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