Aetna "Select Provider" Listing - High-Tech Radiology ALACHUA COUNTY Gainesville Doctors Imaging Group at Diagnostic Imaging Center 9401063, 59193 Svcs: CNM, PET Doctors Imaging Group, 7253819, 8112934 Gainesville MRI Center 4340 West Newberry Road, Suite 104 Gainesville, FL 32607 Phone: 352-377-3100 / Fax: 352-377-1286 5591235, 3492376 Invision North Florida Outpatient Imaging Center 7036457, 6321382 6605 Northwest 9th Blvd. Phone: 352-333-4703 / Fax: 352-333-4763, CT, PET 7036457, 7903263, Suite B Phone: 352-333-4703 / Fax: 352-333-4763, PET BAKER COUNTY Macclenny Upright MRI 7305889, 3102955 Ed Fraser Memorial Hospital 159 North 3rd Street Macclenny, FL 32063 A1 Imaging of 5981749, 33926 1566 Kingsley Avenue Phone: 877-800-2450 / Fax: 904-278-2129 Diagnostic Health, 2128 Park Avenue Phone: 305--69-2222 / Fax: 305--69-2233 8720659, 7691002 7691427, 5801919 2020 Profesional Center Drive Phone: 904-272-2800 / Fax: 904-272-4760, CNM, CT, PET 7691427, 2471940 2021 Kingsley Avenue, Suite 108 Phone: 904-272-9217 / Fax: 904-272-9652 Southern Cardiac Nuclear Imaging, 7443680, 7132913 1590 Island Lane, Suite A, FL 32003 Phone: 352-332-8991 / Fax: 352-332-8996 Svcs: CNM A1 Imaging of Mandarin 7067195, 8962747 3753 Cardinal Point Drive, FL 32223 Phone: 877-800-2450 / Fax: 904-448-4674 Altec Diagnostic Imaging, Inc. 5562 Spring Park Road Phone: 904-854-6741 / Fax: 904-425-3144, CT 7833632, 585032 Ascent Diagnostic Imaging of, 9451206, 9502670 5210 Belfort Road Phone: 904-470-4006 / Fax: 904-281-7601 Svcs: CT, PET Baymeadows MRI 7999 Philips Hwy., Suite 311 Phone: 904-683-6667 / Fax: 904-783-8419 Svcs: MR 9152911, 1824372 Comprehensive Medical Imaging- Northside 7917175, 8171960 1215-4 Dunn Avenue Phone: 904-696-8400 / Fax: 904-696-8499 Svcs: CT Eiber Radiology, Inc.() 5210 Belfort Road, Suite 130 Phone: 904-281-7600 / Fax: 305-817-6490 Svcs: CT, PET 7450897, 3703030 Imaging Center at Forbes,LLC 2345 Forbes Street, FL 32204 Phone: 904-391-1600 / Fax: 904-391-1605, CNM, CT 7542455, 167307 Imaging Center at Lakewood, LLC 2301 University Blvd. West, FL 32217 Phone: 904-448-2299 / Fax: 904-448-2298 7090416, 5871776 Beach Medical Imaging, Inc. 7842141, 7601176 2700 Riverside Avenue, Suite 1, FL 32205 Phone: 904-381-9994 / Fax: 904-389-6866 7842141, 3131794 3316 South 3rd Street, Suite 101, FL 32250 Phone: 904-241-7772 / Fax: 904-241-7702 7842141, 3072360 6138 Kennerly Road, Suite 101 Phone: 904-733-7770 Upright MRI 4933 University Blvd. West 7305889, 9660755 Precision Imaging Center 7860 Gate Pkwy., Suite 123 Phone: 904-996-8100, PET 7448900, 2882891 Premier Open MRI Center, L.C. 916 Dante Place, FL 32207 Phone: 904-396-6736 / Fax: 904-396-8601 7036084, 1191337 Radiology Consultants of MRI, Inc. 7044761, 4542544 7999 Phillips Hwy., Suite 310 Phone: 904-652-0614 / Fax: 904-652-0621 Riverside Imaging Center 4171 Roosevelt Blvd., FL 32210 Phone: 904-389-7474 / Fax: 904-389-7433 5836401, 49452 San Jose Imaging Center, LLC 9872 San Jose Blvd., FL 32257 Phone: 904-268-1080 / Fax: 904-268-3060, CT 9424083, 371780 MR - Closed MRI OMR - Open MRI CNM - Cardio Nuclear Medicine CT - CAT Scan PET - Positron Emission Tomography 1 of 3
Aetna "Select Provider" Listing - High-Tech Radiology 7691427, 8171960 1215-4 Dunn Avenue Phone: 904-696-8400 / Fax: 904-696-8499, CNM, CT, PET 7691427, 195180 4063 Salisbury Road, Suite 100 Phone: 904-281-0133 / Fax: 904-281-9864 7691427, 49452 4171 Roosevelt Blvd., FL 32210 Phone: 904-389-7474 / Fax: 904-389-7433, CNM, CT, PET 7691427, 6530569 6500 Fort Caroline Road, Suite B, FL 32277 Phone: 904-745-5900 / Fax: 904-745-3737 Southern Cardiac Nuclear Imaging, 7443680, 5290706 6484 Fort Caroline Road, FL 32277 Phone: 352-332-8991 / Fax: 352-332-8996 Svcs: CNM Specialty Imaging, LLC 3716 University Blvd. South, Suite 2 Phone: 904-329-4877 / Fax: 904-329-7117 9277697, 7841410 Beach Beaches Open MRI, LLC 350 10th Avenue, South Beach, FL 32250 Phone: 904-247-2220 7099065, 1890804 FLAGLER COUNTY Palm Coast Palm Coast Imaging Center 5188727, 8401128 3 Pine Cone Drive, Suite 101 Palm Coast, FL 32137 Phone: 386-446-7578 / Fax: 386-446-9437, CNM, CT, PET Town Center Imaging 21 Hospital Drive, Suite 130 Palm Coast, FL 32164 Phone: 386-445-4400 / Fax: 386-447-5665 9348283, 7763397 Belleview Belleview Imaging Center, 7275442, 8101605 10762 Southeast US Hwy. 441 Phone: 352-347-5225 / Fax: 352-347-7797 Svcs: MR, CNM, CT 7275442, 3500974 5925 Southeast Abshier Blvd. Phone: 352-307-5070 / Fax: 352-307-5030, CNM, CT Dunnellon Citrus Diagnostic Center 11371 North Williams Street Dunnellon, FL 34432 Phone: 352-489-8987 / Fax: 352-489-8904 Svcs: MR 4593754, 8133955 A1 Imaging of 301 Southeast 17th Street, Suite 102 Phone: 352-622-7459 / Fax: 352-622-9238 7834324, 5821735 Advanced Imaging Center Inc. 2300 Southeast 17th Street, Bldg. 800 Phone: 352-867-9606 4603779, 5392998 Advanced Imaging of, Inc. 8150 Southwest State Road 200, Suite 200, FL 34481 Phone: 352-854-2020 / Fax: 352-873-7206, PET 5263618, 1650780 Clinical PET of 7345351, 5740920 3233 Southwest 33rd Road, Suite 101, PET 7345351, 6713835 3233 Southwest 33rd Road, Suite 31, PET 7345351, 3531998 7494 Southwest 60th Avenue, FL 34476 Phone: 352-291-0014 / Fax: 352-291-0057 PET Services of Florida, 1541 Southwest 1st Avenue, Suite 101 Phone: 352-795-5628 Svcs: CT, PET 7297596, 1362606 X-Ray & Imaging Center 2621 Southeast Lake Weir Road Phone: 352-369-0770 / Fax: 352-369-0772 Svcs: CT 5593594, 7481450 NASSAU COUNTY Fernandina Beach Nassau Open MRI, LLC 7143548, 1912031 1699 South 14th Street, Suite 16-17 Fernandina Beach, FL 32034 Phone: 904-491-7700 / Fax: 904-491-7701 PUTNAM COUNTY Palatka Doctors Imaging Group at Putnam Radiology Group 9204077, 1940644 6121 St. Johns Avenue Palatka, FL 32177 Phone: 386-326-0077 / Fax: 386-326-0188 SAINT JOHNS COUNTY St. Augustine A1 Imaging of St. Augustine 7008104, 9702708 200 Southpark Blvd., Suite 210 Phone: 904-819-0920 / Fax: 904-819-0299 St. Augustine Imaging Center 190 Southpark Blvd., Suite 101 Phone: 904-829-0764 / Fax: 904-829-2221, PET 7623187, 7821433 Note(s): These procedures may require preauthorization. Aetna's radiology management vendors may have more current information that will replace the information contained within this List. MR - Closed MRI OMR - Open MRI CNM - Cardio Nuclear Medicine CT - CAT Scan PET - Positron Emission Tomography 2 of 3
Aetna "Select Provider" Listing - High-Tech Radiology Effective January 1, 2012, Aetna requires all providers administering high-tech radiology services to be accredited by the American College of Radiology and/or the Intersocietal Accreditation Commission. Any provider who performs these services but is not accredited at the time of service may not be eligible for payment. Aetna s radiology management vendors will offer alternative accredited providers in accordance with these standards. MR - Closed MRI OMR - Open MRI CNM - Cardio Nuclear Medicine CT - CAT Scan PET - Positron Emission Tomography 3 of 3
Aetna "Select Provider" Listing - Low-Tech Radiology ALACHUA COUNTY Gainesville Doctors Imaging Group at Diagnostic Imaging Center 9401063, 59193 Doctors Imaging Group Vascular and Interventional Physicians 9872087, 5441153 6685 Northwest 9th Blvd. Phone: 352-333-7847 / Fax: 352-333-0990 Svcs: FL, US, M Doctors Imaging Group,, FL, US, M 7253819, 8112934 Gainesville Women's Center for Radiology 7635818, 6120125 6820 Northwest 11th Place Phone: 352-331-0115 / Fax: 352-331-2044, US, S, BD, M BAKER COUNTY Macclenny Upright MRI 7305889, 3102955 Ed Fraser Memorial Hospital 159 North 3rd Street Macclenny, FL 32063, US Diagnostic Health, 8720659, 7691002 2128 Park Avenue Phone: 904-264-9922 / Fax: 904-264-8650, FL, US, S, M 7691427, 5801919 2020 Profesional Center Drive Phone: 904-272-2800 / Fax: 904-272-4760 7691427, 2471940 2021 Kingsley Avenue, Suite 108 Phone: 904-272-9217 / Fax: 904-272-9652, FL, US, M Advanced Diagnostic Group 5433613, 4751110 6800 Southpoint Pkwy., Suite 401 Phone: 888-234-5575 / Fax: 813-849-6349 Altec Diagnostic Imaging, Inc. 7833632, 585032 5562 Spring Park Road Phone: 904-854-6741 / Fax: 904-425-3144 Imaging Center at Forbes,LLC 7542455, 167307 2345 Forbes Street, FL 32204 Phone: 904-391-1600 / Fax: 904-391-1605 Imaging Center at Lakewood, LLC 7090416, 5871776 2301 University Blvd. West, FL 32217 Phone: 904-448-2299 / Fax: 904-448-2298 Beach Medical Imaging, Inc. 7842141, 7601176 2700 Riverside Avenue, Suite 1, FL 32205 Phone: 904-381-9994 / Fax: 904-389-6866 7842141, 3131794 3316 South 3rd Street, Suite 101, FL 32250 Phone: 904-241-7772 / Fax: 904-241-7702, BD 7842141, 3072360 6138 Kennerly Road, Suite 101 Phone: 904-733-7770 Upright MRI 7305889, 9660755 4933 University Blvd. West, US Monument/9A Imaging Center 7846207, 8021404 1201 Monument Road, Suite 101, FL 32225 Phone: 904-855-0700 Precision Imaging Center 7448900, 2882891 7860 Gate Pkwy., Suite 123 Phone: 904-996-8100, US, S, BD, M San Jose Imaging Center, LLC 9424083, 371780 9872 San Jose Blvd., FL 32257 Phone: 904-268-1080 / Fax: 904-268-3060, US, S, M 7691427, 8171960 1215-4 Dunn Avenue Phone: 904-696-8400 / Fax: 904-696-8499 7691427, 195180 4063 Salisbury Road, Suite 100 Phone: 904-281-0133 / Fax: 904-281-9864 7691427, 49452 4171 Roosevelt Blvd., FL 32210 Phone: 904-389-7474 / Fax: 904-389-7433 7691427, 6530569 6500 Fort Caroline Road, Suite B, FL 32277 Phone: 904-745-5900 / Fax: 904-745-3737 Specialty Imaging, LLC 9277697, 7841410 3716 University Blvd. South, Suite 2 Phone: 904-329-4877 / Fax: 904-329-7117, US, M Beach Beaches Open MRI, LLC 7099065, 1890804 350 10th Avenue, South Beach, FL 32250 Phone: 904-247-2220, BD FLAGLER COUNTY Palm Coast Palm Coast Imaging Center 5188727, 8401128 3 Pine Cone Drive, Suite 101 Palm Coast, FL 32137 Phone: 386-446-7578 / Fax: 386-446-9437 Town Center Imaging 9348283, 7763397 21 Hospital Drive, Suite 130 Palm Coast, FL 32164 Phone: 386-445-4400 / Fax: 386-447-5665, US, S, BD, M Belleview Belleview Imaging Center, 7275442, 8101605 10762 Southeast US Hwy. 441 Phone: 352-347-5225 / Fax: 352-347-7797, US X - X-Ray FL - Fluoroscopy US - Ultrasound S - Sonogram BD - Bone Density M - Mammography 1 of 2
Aetna "Select Provider" Listing - Low-Tech Radiology 7275442, 3500974 5925 Southeast Abshier Blvd. Phone: 352-307-5070 / Fax: 352-307-5030, US, S, BD Dunnellon Citrus Diagnostic Center 11371 North Williams Street Dunnellon, FL 34432 Phone: 352-489-8987 / Fax: 352-489-8904, US 4593754, 8133955 Advanced Imaging Center Inc. 4603779, 5392998 2300 Southeast 17th Street, Bldg. 800 Phone: 352-867-9606 4603779, 6441482 2300 Southeast 17th Street Phone: 352-867-9606, FL, US, M Advanced Imaging of, Inc. 8150 Southwest State Road 200, Suite 200, FL 34481 Phone: 352-854-2020 / Fax: 352-873-7206, US, S, BD, M 5263618, 1650780 Clinical PET of 7345351, 5740920 3233 Southwest 33rd Road, Suite 101, US, M 7345351, 6713835 3233 Southwest 33rd Road, Suite 31, US, M 7345351, 3531998 7494 Southwest 60th Avenue, FL 34476 Phone: 352-291-0014 / Fax: 352-291-0057, US, M PUTNAM COUNTY Palatka Doctors Imaging Group at Putnam Radiology Group 9204077, 1940644 6121 St. Johns Avenue Palatka, FL 32177 Phone: 386-326-0077 / Fax: 386-326-0188 SAINT JOHNS COUNTY Raina Imaging, Inc. 5189613, 713387 450-106 State Road 13 North, Suite 263, FL 32259 Phone: 866-992-9749 / Fax: 904-992-8980, US St. Augustine St. Augustine Imaging Center 190 Southpark Blvd., Suite 101 Phone: 904-829-0764 / Fax: 904-829-2221 7623187, 7821433 X - X-Ray FL - Fluoroscopy US - Ultrasound S - Sonogram BD - Bone Density M - Mammography 2 of 2
Aetna "Select Provider" Listing - Ambulatory Surgery ALACHUA COUNTY Gainesville Laser and Outpatient Surgery Center, 7179862, 3072827 6925 Northwest 11th Place Phone: 352-331-1590 / Fax: 352-331-0995 Svcs: GEN, LT, OPT, ORP, UR, Pain Management, Plastic North Florida Surgical Pavillion 5946098, 7890290 6705 Northwest 10th Place Phone: 352-333-4555 Svcs: GEN, INF, OPT, ORP, UR, ENT, Gynecology, Neurosurgery, Pain Management, Plastic Surgery, Podiatry Fleming Island Surgery Center, LLC 7092883, 863719 1670 B Eagle Harbor Pkwy., FL 32003 Phone: 904-644-0700 / Fax: 904-644-0759 Svcs: GEN, EN, INF, LT, OPT, ORP, UR, ENT, Plastic, Podiatry Surgery Center - HCA Affiliate 8207669, 316926 2050 Professional Center Drive Phone: 904-272-2550 / Fax: 904-272-7911 Svcs: GEN, EN, INF, LT, OPT, ORP, UR Center One Surgery Center 7025929, 4852969 10475 Centurion Pkwy. North, Suite 101 Phone: 904-652-2328 / Fax: 904-565-9217 Svcs: ORP, UR, Pain Management, ENT, Plastic, Podiatry Healthsouth Medical Partners Surgery Center 5469169, 3290599 4545 Emerson Street, FL 32207 Phone: 904-399-2600 / Fax: 904-399-2300 Svcs: GEN, EN, OPT, ORP, UR, ENT Surgery Center - HCA Affiliate 8203035, 2312674 7021 A. C. Skinner Pkwy. Phone: 904-281-0021 / Fax: 904-381-0988 Svcs: GEN, EN, INF, LT, OPT, ORP, BA, ENT, Plastic, Podiatry Parkside Surgery Center - HCA Affiliate 8205125, 381158 2731 Park Street, FL 32205 Phone: 904-389-1077 Svcs: GEN, EN, INF, LT, ORP, BA, UR, Podiatry/ENT Plaza Surgery Center-HCA Affiliate 8203050, 761466 6138 Kennerly Road Phone: 904-208-4120 / Fax: 904-208-4135 Svcs: GEN, EN, INF, LT, OPT, ORP, UR, ENT, Plastic, Podiatry Southpoint Surgery Center, LLC 7127855, 8283103 7051 South Point Pkwy. Phone: 904-854-4854 / Fax: 904-483-5985 Svcs: GEN, INF, OPT, ORP, BA, Pain Management, ENT, Plastic Beach Beach Surgery Center, L.P. 7370249, 4651581 3316 South 3rd Street, Suite 200 Beach, FL 32250 Phone: 904-247-8181 / Fax: 904-247-8101 Svcs: GEN, EN, INF, LT, OPT, ORP, BA, UR, Podiatry Mid-Florida Endoscopy and Surgery Center, LLC 9603574, 8944289 1950 Southwest 18th Court, Suite 200 Phone: 352-861-8555 / Fax: 352-401-0124 Svcs: EN, OPT Surgery Center Of 5372056, 5870168 3241 Southwest 34th Street Phone: 352-237-5906 / Fax: 352-237-5785 Svcs: GEN, EN, INF, ORP, UR, Pain Management/ENT SAINT JOHNS COUNTY St. Augustine St. Augustine Surgery Center, 7399875, 7521045 180 Southpark Blvd. Phone: 904-823-1974 Svcs: GEN, LT, OPT, ORP, UR, Pain Management, ENT, Podiatry Note(s): Some ambulatory procedures require the physician to notify Aetna prior to performing services (e.g., colonoscopy and other scope procedures). These procedures were not used to determine this listing. GEN - General Surgery EN - Endoscopy INF - Infertility LT - Lithotripsy OPT - Opthalmology ORP - Orthopedics BA - Bariatric UR - Urology 1 of 1
Aetna "Select Provider" Listing - Sleep Studies Fleming Island Florida Center of Sleep Medicine, Inc 5930808, 2194115 1679 Eagle Harbor Pkwy., Suite A Fleming Island, FL 32003 / Fax: 904-215-7557 Florida Center of Sleep Medicine, Inc 5930808, 7671694 1409 Kingsley Avenue, Building 2 / Fax: 904-739-0530 5930808, 7153087 1679 Eagle Harbor Pkwy., Suite A, FL 32003 / Fax: 904-215-7557 Sleep Center LLC 1542 Kingsley Avenue, Suite 138 Phone: 904-269-0334 / Fax: 904-269-0374 7528933, 172150 Atlantic Beach Flagler Diagnostic & Sleep Disorder Center 7029692, 1611398 645 Mayport Road, Suite 2 Atlantic Beach, FL 32233 Phone: 904-586-1229 / Fax: 904-586-2887 American Sleep Medicine 7900 Belfort Pkwy., Suite 300 Phone: 904-281-0107 7910675, 6352245 Florida Center of Sleep Medicine, Inc 5930808, 2111322 1361 13th Avenue South, Suite 110, FL 32250 5930808, 6521686 3627 University Blvd. South, Suite 540 5930808, 782403 425 North Lee Street, Suite 204, FL 32204 Phone: 904-357-3669 / Fax: 904-739-0530 5930808, 7933123 Hampton Professional Park 7807 Baymeadows Road East, Suite 202 / Fax: 904-215-7557 5930808, 4894360 9759 San Jose Blvd., Building 2, Suite 7, FL 32257 5930808, 4313313 9759 San Jose Blvd., Bldg. 2 Suite 7, FL 32257 North Florida Sleep Solutions, Inc 13453 North Main Street, Suite 304 Phone: 904-374-5226 / Fax: 904-374-3137 9612664, 3374139 Sleep Center LLC 4301 Confederate Pt Road, apt 186, FL 32210 Phone: 386-698-3737 7528933, 6634366 Sleep Telemedicine Services 7259587, 5621719 1215 Dunn Avenue, Suite 8 Phone: 904-220-7655 / Fax: 904-220-8096 7259587, 4972651 13171 Atlantic Blvd., Suite 100, FL 32225 Phone: 904-220-7655 / Fax: 904-220-8096 Welcome Homecare Sleep Disorder Clinics 7660806, 5200849 9570 Regency Square Blvd., FL 32225 Phone: 904-725-7100 / Fax: 904-725-0059 FLAGLER COUNTY Bunnell Flagler Diagnostic & Sleep Disorder Center 7029692, 633074 4721 East Moody Blvd., Building 1, Suite 104 Bunnell, FL 32110 Phone: 386-586-1229 / Fax: 386-586-2887 Palm Coast Advanced Sleep and Respiratory Institute, PA 7936611, 7294116 50 Leanni Way, Unit D-1 and D-2 Palm Coast, FL 32137 Phone: 386-597-4905 / Fax: 386-597-4906 Florida Sleep Solutions, Inc 9035493, 8714070 9401 Southwest State Road, Bldg. 2000, Suite 200, FL 34481 Phone: 352-873-7500 1 of 1