Provider Demographics
NPI:1831183607
Name:WEST HERNANDO DIAGNOSTIC AND M.R. CENTER, INC
Entity type:Organization
Organization Name:WEST HERNANDO DIAGNOSTIC AND M.R. CENTER, INC
Other - Org Name:
Other - Org Type:
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 1:3315 COMMERCIAL WAY
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-2699
Mailing Address - Country:US
Mailing Address - Phone:352-688-5860
Mailing Address - Fax:352-688-4347
Practice Address - Street 1:3315 COMMERCIAL WAY
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606-2699
Practice Address - Country:US
Practice Address - Phone:352-688-5860
Practice Address - Fax:352-688-4347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-07
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL272166000Medicaid
FLCC0618OtherRAILROAD MEDICARE
FL272166000Medicaid