Provider Demographics
NPI:1467429209
Name:WEST HERNANDO DIAGNOSTIC & MR CENTER
Entity Type:Organization
Organization Name:WEST HERNANDO DIAGNOSTIC & MR CENTER
Other - Org Name:WEST HERNANDO DIAGNOSTIC & MR CENTER SEVEN HILLS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:352-799-0046
Mailing Address - Street 1:491 MARINER BLVD
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609
Mailing Address - Country:US
Mailing Address - Phone:352-688-4111
Mailing Address - Fax:352-688-7222
Practice Address - Street 1:491 MARINER BLVD
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609
Practice Address - Country:US
Practice Address - Phone:352-688-4111
Practice Address - Fax:352-688-7222
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WEST HERNANDO DIAGNOSTIC & MR CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-03-01
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL272166004Medicaid