MANATEE DIAGNOSTIC CENTER WEST NPI 1972872604

NPI Information

  • NPI: 1972872604
  • Provider Name: MANATEE DIAGNOSTIC CENTER WEST
  • Classification: Radiology - 2085R0202X
  • Specialization: Diagnostic Radiology
  • Entity Type: Organization
  • CLIA Number: 10D2009165
  • Address: 2211 60TH ST WEST
    BRADENTON, FL
    ZIP 34209
  • Phone: (941) 747-3034

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NPI Details

MANATEE DIAGNOSTIC CENTER WEST is a diagnostic radiology radiology in Bradenton, FL. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. MANATEE DIAGNOSTIC CENTER WEST NPI is 1972872604. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2211 60TH ST WEST
BRADENTON, FL
ZIP 34209
Phone: (941) 747-3034

The provider's authorized official is Davis W Graham .
The authorized official title is Executive Director and has the following contact phone number (941) 747-3034.

The CLIA number assigned to this NPI record is 10D2009165 - other - independent diagnostic t with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/27/2011 and was last updated on 12/27/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12085R0202XRadiologyDiagnostic RadiologyME6540FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1D62394MEDICARE UPINFLORIDA
248245500MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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