Provider Demographics
NPI:1316985658
Name:BOWES IMAGING CENTER LLC.
Entity type:Organization
Organization Name:BOWES IMAGING CENTER LLC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:A
Authorized Official - Last Name:BOWES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-782-0490
Mailing Address - Street 1:6207 CORTEZ RD W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34210-2602
Mailing Address - Country:US
Mailing Address - Phone:941-782-0490
Mailing Address - Fax:941-782-0496
Practice Address - Street 1:6207 CORTEZ RD W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34210-2602
Practice Address - Country:US
Practice Address - Phone:941-782-0490
Practice Address - Fax:941-782-0496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC58442085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL280453100Medicaid
FL280453100Medicaid
FLU3609Medicare UPIN