Aetna "Select Provider" Listing - Radiology Tampa - January, 2012 CITRUS COUNTY

Transcription

1 FLORIDA CHARLOTTE COUNTY Port Charlotte Advanced Imaging of Port Charlotte, , Tamiami Trail, Unit 1 Port Charlotte, FL Phone: / Fax: Svcs: MR, OMR, CNM, CT, PET, X, US, BD, M Imaging for Life* , Tamiami Trail, Suite 101 Port Charlotte, FL Phone: / Fax: Hours: M-F 8:00 am - 5:00 pn Svcs: CT, PET Partner's Imaging of Charlotte* , Tamiami Trail, Suite 204 Port Charlotte, FL Phone: / Fax: Hours: M-F 7:00 am - 6:00 pm Svcs: MR S.W. Florida Regional Imaging , Tamiami Trail Port Charlotte, FL Phone: / Fax: Svcs: MR, OMR, CT, X, US, M , Tamiami Trail Port Charlotte, FL Phone: / Fax: Svcs: MR, OMR, CT, X, US, M S.W. Florida Regional Imaging II, , Cochran Blvd., Suite 3 Port Charlotte, FL Phone: / Fax: Svcs: MR, OMR, CNM, CT, PET, X, FL, US, S, BD, M Punta Gorda S.W. Florida Regional Imaging II, , East Olympia Avenue Punta Gorda, FL Phone: / Fax: Svcs: MR, OMR, CNM, CT, PET, X, FL, US, S, BD, M CITRUS COUNTY Beverly Hills PET Services of Florida, L.L.C , North Lecanto Hwy., Suite A Beverly Hills, FL Phone: Svcs: CT, PET Crystal River Citrus Diagnostic Center* , North Citrus Avenue Crystal River, FL Phone: / Fax: Svcs: MR, OMR, CNM, CT, PET, X, FL, US, BD, M Homosassa Homosassa Open MRI, Inc.* , West Aquaduct Street Homosassa, FL Phone: / Fax: Svcs: OMR, X Sugar Mill Diagnostic Imaging, LLC , South Suncoast Blvd. Homosassa, FL Phone: / Fax: Svcs: CT, X, US, BD, M Inverness Citrus Open MRI Center* , East Golf To Lake Hwy. Inverness, FL Phone: / Fax: Svcs: OMR, CNM, CT, PET, X, FL, US, S, BD, M Inverness Medical Imaging, , Hwy. 44 West Inverness, FL Phone: / Fax: Svcs: MR, CT, X, FL, US, BD, M COLLIER COUNTY Naples American Radiology Services Banyan Center, , Tamiami Trail North, Suite 101 Phone: Hours: M-F 8:00 a.m. - 5:00 p.m. Svcs: MR, CNM, CT, X, US Partner's Imaging of Naples* , Goodlette Road, Suite 101 Phone: / Fax: Hours: M-F 7:00 am - 11:00 pm Svcs: MR, CT ProScan Imaging Naples, , Tamiami Trail North Phone: / Fax: Hours: M-F 7:00 am - 11:00 pm Svcs: MR, CT , Airport Pulling Road Naples, FL Phone: / Fax: Hours: M-F 7:00 am - 11:00 pm, Sat 8:00 am - 4:00 pm Svcs: MR, X, BD, M Radiology Regional Center* , Goodlette Road Phone: / Fax: Svcs: MR, OMR, CNM, CT, PET, X, FL, US, BD, M Stand-Up MRI of South West Florida* , Executive Drive Naples, FL Phone: / Fax: Svcs: OMR HERNANDO COUNTY Brooksville Advanced Imaging Concepts, P.L.* , Cortez Blvd. Brooksville, FL Phone: / Fax: Hours: M-F 7:30 a.m. - 5:30 p.m. Svcs: MR, OMR, CNM, CT, PET, X, US, M Summit Imaging-HCA Affiliate* , Cortez Blvd. Brooksville, FL Phone: / Fax: Hours: Mon 8:00 am - 8:00 pm T-F 8:00 am - 5:00 pm, Sat 8:00 am - 1:00 pm Svcs: MR, CNM, CT, PET, X, FL, US, BD, M West Hernando Diagnostic and MRI Center* , Cortez Blvd. Brooksville, FL Phone: / Fax: Hours: M-F 8:00 am - 5:00 extended hrs upon request Svcs: MR, OMR, CT, X, US, BD, M 1 of 7

2 Spring Hill , Northcliffe Blvd. Spring Hill, FL Phone: / Fax: Sat by Appt Svcs: OMR, CT, X, US, M Spring Hill MRI* , Toucan Trail Spring Hill, FL Phone: / Fax: Hours: M-F 8:00 am - 7:00 pm Svcs: MR, CT, X, US, M Sugar Mill Diagnostic Imaging, LLC , Mariner Blvd. Spring Hill, FL Phone: / Fax: Svcs: CT, X, US, BD, M West Hernando Diagnostic and MRI Center* , Commercial Way, Suite A Spring Hill, FL Phone: / Fax: Hours: M-F 8:00 am - 5:00 extended hrs upon request Svcs: MR, OMR, CT, X, FL, US, BD, M , Mariner Blvd. Spring Hill, FL Phone: / Fax: Hours: M-S 8:00 am - 5:00 pm Svcs: MR, CT, X, US, M HIGHLANDS COUNTY Sebring Highlands Breast & Imaging Center, L.L.C , Medical Center Sebring, FL Phone: Svcs: X, US, M HILLSBOROUGH COUNTY Brandon Bloomingdale Radiology Center* , Bell Shoals Road Phone: / Fax: Hours: M-F 7:00-5:30 Sat:7:30-2:00 Svcs: MR, CT, PET, X, US, BD, M Brandon Open MRI* , Vonderberg Drive Phone: / Fax: Hours: M-F 8:00 am - 8:00 pm Svcs: OMR Community Diagnostic of Brandon* , Vonderburg Road, Suite 111 Phone: / Fax: Hours: M-Th 7:00 am - 7:00 pm, F 7:00 am - 5:30 pm Svcs: MR, CT, X , Oakfield Drive Phone: Sat by Appt Svcs: OMR, X Signet Diagnostic Imaging Services, L.L.C.* , West Robertson Street Phone: Hours: M-F 7:00 am - 10:00 Sat 8:00 am - 1:00 pm Svcs: MR, CNM, CT, PET, X, US, BD, M Total Imaging - Parsons, , South Parsons Avenue, Suite 100 Phone: / Fax: Hours: M-F 8:00 a.m. - 5:00 p.m. Svcs: MR, CNM, CT, X, US, M Tower Diagnostic of Brandon-HCA Affiliate* , Oakfield Drive Phone: / Fax: SS by appt Svcs: MR, OMR, CNM, CT, X, FL, US, BD, M Best Open MRI* , US Hwy. 27 North Sebring, FL Phone: / Fax: Hours: M-Thur 8 am - 5 pm; Fri 8 am - 12 pm Svcs: OMR, CT, X, US West Florida Pet Services, , Vonderburg Drive, Suite 3009 Phone: / Fax: Svcs: PET Women's Diagnostic Center* , Oakfield Drive Phone: / Fax: Svcs: X, US, M Lutz BayCare Outpatient Imaging* , Van Dyke Road Lutz, FL Phone: / Fax: Hours: M-F 7:00 am - 5:30 pm Svcs: MR, CT, X, US, M Tower Radiology Center-North Dale Mabry* , North Dale Mabry Hwy. Lutz, FL Phone: / Fax: Svcs: OMR, X, US, BD, M Riverview , Hwy. 301 South Riverview, FL Phone: Sat by Appt Svcs: MR, CT, X, US, BD, M Ruskin Sun City Center Open MRI , Cortaro Drive, Suite 8 Ruskin, FL Phone: Svcs: MR, OMR, X, BD Sun City Center Total Imaging of Sun City-HCA Affiliate* , Sun City Center Blvd. Sun City Center, FL Phone: / Fax: SS by appt Svcs: MR, OMR, CT, X, US, M Tampa Advanced Diagnostic Group* , West Martin L King Blvd., Suit F Tampa, FL Phone: / Fax: Svcs: OMR, X , West Waters Avenue, Suite 106 Tampa, FL Phone: / Fax: Svcs: MR, X , West Martin L King Blvd., Suite 103 Tampa, FL Phone: / Fax: Svcs: MR, OMR, X 2 of 7

3 Bay Area Imaging Services , North Armenia Avenue, Suite 102 Tampa, FL Phone: Hours: M-F 8:00 am - 8:00 pm Sat 8:00 am - 12:00 pm Svcs: MR, OMR, X, US Bay View Radiology* , North Dale Mabry Hwy., Suite 150 Tampa, FL Phone: / Fax: Svcs: MR, CT, X, US, M BayCare Outpatient Imaging* , Racetrack Raod Tampa, FL Phone: / Fax: Hours: M-F 7:00 am - 5:30 pm Svcs: MR, CT, X, US, M , West Martin Luther King Blvd. Tampa, FL Phone: / Fax: Svcs: MR, CNM, CT, PET, X, US, M , Tower Breast Diagnostic Center Habana* 4719 North Habana Avenue Tampa, FL Phone: / Fax: Hours: M-F 7:30-5:00, Sat 7:30 am - 2:00 pm Svcs: MR, CNM, CT, PET, X, FL, US, BD, M Clearview Open MRI , West Hamilton Avenue, Suite B Tampa, FL Phone: / Fax: Hours: M-F 6:30 am - 8:30 pm; SS by appt Svcs: MR, OMR, X Park Place MRI* , North Dale Mabry, Suite 144 Tampa, FL Phone: / Fax: Hours: M-F 6:00 am - 10:00 pm Sat 8:00 am - 4:00 pm Svcs: MR, OMR, CT, X, US Phycon Medical Sciences, Inc.* , North 56th Street, Suite A Tampa, FL Phone: / Fax: Hours: M-F 8:30 am - 5:00 pm Svcs: US , West Kennedy Blvd. Tampa, FL Phone: / Fax: Sat by Appt Svcs: OMR, X , North Armenia Avenue, Suite B Tampa, FL Phone: / Fax: Sat by Appt Svcs: MR, CT, PET, X, FL, US, M SDI Diagnostic Imaging , West Swann Avenue Tampa, FL Phone: Hours: M-F 7:15 am - 5:00 pm Svcs: OMR, CT, X, FL, US, M , North Armenia Avenue Tampa, FL Phone: Hours: M-F 7:15 am - 5:00 pm Svcs: MR, CT, X, US, M Signet Diagnostic Imaging Services, L.L.C.* , Henderson Blvd. Tampa, FL Phone: / Fax: Hours: M-F 7:00 am - 8:00 pm Sat 8:00 am - 1:00 pm Svcs: MR, CNM, CT, PET, X, US, BD, M Tampa Bay Imaging, , West Martin K. King Jr. Blvd., Suite 130 Tampa, FL Phone: Hours: M-F 7:30 am - 10:00 pm Svcs: MR, CT Tower Breast Diagnostic Center - Northside* , University Square Drive Tampa, FL Phone: / Fax: Svcs: MR, X, US, M Tower Radiology Center Bruce B. Downs* , Grand Pavilion Drive Tampa, FL Phone: / Fax: Hours: M-F 7:00 am - 7:30 pm Sat 8:00 am - 2:00 pm Svcs: MR, CNM, CT, X, FL, US, BD Tower Radiology Center South Tampa* , South Lois Avenue Tampa, FL Phone: / Fax: Svcs: MR, OMR, CT, X, US, BD, M , Tower Diagnostic Center* , North Habana Avenue Tampa, FL Phone: / Fax: Hours: M-F 7:30 am - 5:00 pm, Sat 7:30 am - 2:00 pm Svcs: MR, CNM, CT, PET, X, FL, US, BD, M Tower Diagnostic Center-Carrollwood* , North Dale Mabry Hwy., Suite 150 Tampa, FL Phone: / Fax: Hours: M-F 7:30 am - 5:00 pm, Sat 7:30 am - 2:00 pm Svcs: MR, CNM, CT, X, FL, US, BD, M Tower Imaging Inc , Grand Pavilion Drive Tampa, FL Phone: Svcs: X, FL, US, M Tower OpenScan MRI* , Bruce B. Downs Blvd. Tampa, FL Phone: / Fax: Svcs: MR, OMR, X, US, M , West Swann Avenue Tampa, FL Phone: / Fax: Svcs: MR, OMR, X, US, M University Diagnostic Institute, LTD.* , USF Alumni Drive Tampa, FL Phone: Svcs: MR, OMR, CT, X Vymed Diagnostic Imaging Tampa, L.L.C.* , North Dale Mabry Hwy., Suite 160 Tampa, FL Phone: Svcs: PET LEE COUNTY Bonita Springs Bonita Community Radiology* , Health Center Blvd. Bonita Springs, FL Phone: Svcs: MR, CT, X, FL, US, BD, M 3 of 7

4 Radiology Regional Center* , Bonita Beach Road Southeast Bonita Springs, FL Phone: / Fax: Svcs: MR, CNM, CT, X, FL, US, M Cape Coral A1 Imaging of Cape Coral* , Del Prado Blvd., UNIT 102 Cape Coral, FL Phone: / Fax: Svcs: MR Advanced Radiology Imaging Associates, , Del Prado Blvd., S-102 Cape Coral, FL Phone: / Fax: Hours: M-F 7:00 am - 6:00 pm Svcs: MR, CNM, CT, X, US, BD , Del Prado Blvd., Suite 230B Cape Coral, FL Phone: / Fax: Hours: M-F 7:00 am - 6:00 pm Svcs: MR, CNM, CT, X, US, BD Radiology Regional Center* , Cape Coral Pkwy. West, Suites E & F Cape Coral, FL Phone: / Fax: Svcs: MR, OMR, CNM, CT, X, FL, US, BD, M , Del Prado Blvd. Cape Coral, FL Phone: / Fax: Svcs: MR, CNM, CT, X, FL, US, BD, M Estero Radiology Regional Center* , Acros Avenue, Suite 101 Estero, FL Phone: / Fax: Svcs: MR, CNM, CT, X, FL, US, BD, M Fort Myers Advanced Radiology Imaging Associates, , Metropolis Avenue Fort Myers, FL Phone: / Fax: Hours: M-F 7:00 am - 6:00 pm Svcs: MR, CNM, CT, X, US, BD Florida Radiology Leasing, , Shell Point Blvd. Fort Myers, FL Phone: / Fax: Hours: M-F 7:30 am - 5:00 pm Svcs: MR, CNM, CT , Barkley Circle, Suite 100 & 101 Fort Myers, FL Phone: / Fax: Hours: M-F 7:30 am - 5:00 pm Svcs: MR, CNM, CT, X, FL, US , South Pointe Blvd. Phone: / Fax: Hours: M-F 7:30 am - 5:00 pm Svcs: MR, CNM, CT, X, FL, US Radiology Regional Center* , Broadway Fort Myers, FL Phone: / Fax: Svcs: MR, CNM, CT, X, FL, US, BD, M , Winkler Road Phone: / Fax: Svcs: MR, CNM, CT, X, FL, US, M , Winkler Road Phone: / Fax: Svcs: MR, CNM, CT, X, FL, US, M , College Pkwy. Phone: / Fax: Svcs: MR, CNM, CT, X, FL, US, M Summerlin Imaging Center* , Barkley Circle, Suite 104 Fort Myers, FL Phone: / Fax: Svcs: MR, CT, X, US Women's Breast Health Center of Fort Myers* , Healthpark Circle, Suite 287 Fort Myers, FL Phone: Hours: M-Th 8:00 am - 5:00 pm, Fri 8:00 am - 4:00 pm Svcs: X Fort Myers Beach Florida Radiology Leasing, , Estero Blvd. Fort Myers Beach, FL Phone: / Fax: Hours: M-F 7:30 am - 5:00 pm Svcs: MR, CNM, CT, X, FL, US Lehigh Acres Radiology Regional Center* , Lee Blvd. Lehigh Acres, FL Phone: / Fax: Svcs: MR, OMR, CNM, CT, X, FL, US, BD, M Sanibel Florida Radiology Leasing, , Periwinkle Way Sanibel, FL Phone: / Fax: Hours: M-F 7:30 am - 5:00 pm Svcs: MR, CNM, CT, X, FL, US MANATEE COUNTY Bradenton Bowes Imaging Center* , Pointe West Blvd., Suite 102 Phone: / Fax: Svcs: MR, CT, X, US Dimensional Imaging, Inc.* , st Avenue West Phone: / Fax: Svcs: MR, CT, X, US Imaging for Life* , th Street Court West, Suite A Phone: / Fax: Svcs: CT, PET Lakewood Ranch Imaging Center , Lakewood Ranch Blvd., Suite 100 Bradenton, FL Phone: / Fax: Hours: M-F 8:00 am - 8:00 pm Svcs: MR, CT, X Manatee Diagnostic Center, LTD* , th Street West Phone: Svcs: MR, CT, X, FL, US, M 4 of 7

5 , Riverside Drive East, Suite 1400 Bradenton, FL Phone: Svcs: MR, CT, X, FL, US, M , Riverside Drive East, Suite 4300 Bradenton, FL Phone: Svcs: MR, CNM, CT, X, FL, US, BD, M Park South Imaging Center , st Avenue West, Suite A Phone: Hours: M-F 7:00 am - 5:00 pm MRI's 6:00 am - 11:00 pm Sat 7:00 am - 3 pm Svcs: MR, CT, PET Partner's Imaging of Bradenton* , th Avenue Circle East, Suite 100 Bradenton, FL Phone: / Fax: Svcs: MR, OMR, CT, PET, X, US, M Precise Ultrasound, Inc.* , Manatee Avenue West Bradenton, FL Phone: / Fax: Svcs: US , State Road 70 Bradenton, FL Phone: / Fax: Sat by Appt Svcs: MR, CT, X, US PASCO COUNTY Dade City Pasco Regional Medical Center* , Fort King Road Dade City, FL Phone: Svcs: X, US, M Hudson Pasco Imaging and Open MRI Center* , Jacque Road Hudson, FL Phone: / Fax: Svcs: MR, OMR, CT, X, FL, US, BD, M Radiology Associates of West Pasco* , State Road 52, Suite 140 Hudson, FL Phone: Svcs: X, US, BD, M New Port Richey Wesley Chapel BayCare Outpatient Imaging* , , Trinity Oaks Blvd Cashford Circle New Port Richey, FL Wesley Chapel, FL Phone: / Fax: Phone: / Fax: Hours: M-F 6:00 am - 7:00 pm Sat by Appt Svcs: MR, CNM, CT, PET, X, FL, US, BD, M Svcs: OMR, CT, PET, X, US, BD, M Excel Medical Imaging, P.L.* , Gulf Drive New Port Richey, FL Phone: / Fax: Svcs: MR, OMR, CNM, CT, PET, X, FL, US, BD, M Radiology Associates of West Pasco* , Little Road New Port Richey, FL Phone: Hours: M-F 9:00 am - 5:30 pm Svcs: US, M , Marine Pkwy. New Port Richey, FL Phone: / Fax: Hours: M-F 7:30 am - 8:00 pm, Sat 8:00 am - 12:00 pm Svcs: X, FL, US, BD, M Signet Diagnostic Imaging Services, L.L.C.* , U.S. Hwy. 19, Suite 102 New Port Richey, FL Phone: / Fax: Svcs: MR, OMR, CNM, CT, X, US Odessa WestCoast Radiology* , Short Aven., #130 Odessa, FL Phone: / Fax: Svcs: OMR, CT, X, US, M Port Richey Florida Institute for Advanced Diagnostic Imaging , US Hwy. 19 Port Richey, FL Phone: / Fax: Svcs: MR, OMR, CNM, CT, PET, X, US, S Trinity , Duck Slough Blvd. Trinity, FL Phone: / Fax: Sat by Appt Svcs: MR, CT, PET, X, US, M Tower Radiology Center Wesley Chapel* , Oak Myrtle Lane Wesley Chapel, FL Phone: / Fax: Hours: M-F 8:00 am - 5:30 pm Svcs: MR, CT, X, US, BD, M Zephyrhills , Gall Blvd. Zephyrhills, FL Phone: / Fax: Sat by Appt Svcs: OMR, CT, X, US, BD, M PINELLAS COUNTY Clearwater Advanced Intervention* , State Road 580, Suite 202 Clearwater, FL Phone: / Fax: Hours: M-F 7:00 am - 6:00 pm Svcs: MR, CT Carlisle Imaging Center* , Pinellas Street, Suite 101 Clearwater, FL Phone: / Fax: Svcs: X, US Susan Cheek Needler Breast Center* , Pinellas Street, Suite 100 Clearwater, FL Phone: / Fax: Svcs: X, US, M WestCoast Radiology* , South Lincoln Avenue, Suite 15 Clearwater, FL Phone: / Fax: Svcs: OMR, CNM, CT, PET, X, US, S, BD, M Dunedin BayCare Outpatient Imaging Center* , Keene Road Dunedin, FL Phone: / Fax: Hours: M-F 8:30 am - 5:00 pm Svcs: MR, OMR, CT, PET, X, US, M 5 of 7

6 Largo BayCare Outpatient Imaging* , Bryan Dairy Road Largo, FL Phone: / Fax: Hours: M-F 8:00 am - 10:00 pm for MRI M-F 8:00 am - 5:00 pm Svcs: MR, OMR, CNM, CT, PET, X, US, BD, M , Belcher Road South Largo, FL Phone: / Fax: Sat by Appt Svcs: MR, CT, X, FL, US, BD, M Oldsmar SDI Diagnostic Imaging , Tampa Road Oldsmar, FL Phone: Hours: M-F 7:30 am - 6:00 pm Sat 8:00 am - 12:00 pm Svcs: MR, CT, X, FL, US, BD, M Palm Harbor Palm Harbor MRI , US Hwy. 19 North, Suite 4 Palm Harbor, FL Phone: Hours: M-F 6:00 am - 12:00 am Sat 7:00 am - 3:00 pm Svcs: MR, CT, X, US, BD, M , Woodlands Pkwy. Palm Harbor, FL Phone: / Fax: Sat by Appt Svcs: MR, OMR, CT, PET, X, FL, US, BD, M WestCoast Radiology* , U.S. Hwy. 19 North Palm Harbor, FL Phone: / Fax: Svcs: MR, CNM, CT, PET, X, US, BD, M Pinellas Park Gateway Radiology Consultants* , Park Blvd. Phone: / Fax: Hours: MTTH 8am-7pm; WF 8am - 5pm Svcs: MR, CNM, CT, PET, X, US, BD, M Magnetic Resonance Associates* , th Street Phone: / Fax: Svcs: MR, OMR National P.E.T.Scan - Pinellas, L.L.C.* , National P.E.T. Scan-Pinellas, LLC th Street North, Suite B Phone: Svcs: MR, CNM, CT, PET Signet Diagnostic Imaging Services, L.L.C.* , Park Blvd. Phone: / Fax: Hours: M-F 8:30 am - 4:30 pm Svcs: MR, OMR, CNM, CT, X Tampa Bay Imaging, , th Street North, Suite 106 Phone: / Fax: Hours: M-F 7:30 am - 11:00 pm Svcs: MR, OMR, CT, X Seminole Open MRI of Pinellas, Inc.* , Seminole Blvd., Suite 101 Seminole, FL Phone: / Fax: Hours: M-F 9:00 am - 5:30 pm Svcs: MR, OMR, CT, X, US, BD, M St. Petersburg BayCare Outpatient Imaging* , Carillon Pkwy. St. Petersburg, FL Phone: / Fax: Svcs: MR, CT, PET, X, FL, US, M Central Imaging Open MRI, Inc.* , Central Avenue St. Petersburg, FL Phone: Sat 8:00 am - 1:00 pm Svcs: MR, OMR, X, US Diagnostic Imaging at Baywalk* , North 1st Avenue St. Petersburg, FL Phone: Hours: M, W, Th, F 7:00 am - 8:45 pm, Tue 8:00 am - 7:00 pm, SS 8:00 am - 4:00 pm Svcs: MR, OMR, CT, PET, X, M Diagnostic Outpatient Center* , th Avenue North, Suite 400 St. Petersburg, FL Phone: Hours: M-F 6:00 am - 10:00 pm Sat 8:00-2:00 pm Svcs: MR, OMR, CT, X, US, BD, M Price, Hoffman, Stone and Associates , st Avenue North St. Petersburg, FL Phone: Svcs: MR, CT, PET, X, US, M , th Street South St. Petersburg, FL Phone: Svcs: MR, CT, PET, X, US, M , th Avenue South St. Petersburg, FL Phone: Svcs: X, US, M Saint Pete MRI , th Avenue North, Suite 206 St. Petersburg, FL Phone: Hours: M-F 6:00 am - 10:00 pm Sat 8:00-4:00 pm Svcs: MR, CT, X, US St Anthonys Pet CT Center* , Fifth Avenue North, Suite 100 St. Petersburg, FL Phone: / Fax: Svcs: MR, CT, PET WestCoast Radiology* , th Street North, Suite B St. Petersburg, FL Phone: / Fax: Svcs: OMR POLK COUNTY Lakeland Lakeland Open MRI , South Florida Avenue Lakeland, FL Phone: Hours: M-F 8:00 am - 4:00 pm Sat 8:00 am - 1:00 pm Svcs: MR, OMR, X 6 of 7

7 Winter Haven Advance Technological Radiology, P.A , Central Avenue East Winter Haven, FL Phone: Svcs: X, FL, US, M SARASOTA COUNTY Sarasota Choice Diagnostic Imaging , Bee Ridge Road, Suite 102 Sarasota, FL Phone: / Fax: Svcs: MR, CT, X, US, BD, M Dimensional Imaging, Inc.* , North Tuttle Avenue Sarasota, FL Phone: / Fax: Svcs: MR, OMR, CT, X, US, BD, M Imaging for Life PET Scan* , Bee Ridge Road, Suite A Sarasota, FL Phone: / Fax: Svcs: CT, PET Partner's Imaging Center of Sarasota, , South Tamiami Trail, Suite 103 Sarasota, FL Phone: / Fax: Svcs: MR, CT, PET, X, US, M Partner's Imaging of East Sarasota* , North Cattlemen Road, Suite 100 Sarasota, FL Phone: / Fax: Svcs: MR, OMR, CT, PET, X, US , Clark Road Sarasota, FL Phone: / Fax: Sat by Appt Svcs: OMR, CT, PET, X, FL, US, BD, M Venice Dimensional Imaging, Inc.* , East Venice Avenue, Suite 101 Venice, FL Phone: / Fax: Svcs: MR, X Partner's Imaging of Venice* , Sunset Lake Blvd., Suite 301 Venice, FL Phone: / Fax: Svcs: MR, CT, PET, X, US Radiology Associates of Venice and Englewood* , Nokomis Avenue South Venice, FL Phone: / Fax: Svcs: X, FL, US, M Note(s): These procedures may require pre-authorization. Aetna's radiology management vendors may have more current information that will supersede the information contained within this List. 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 performing these services who has not been accredited at the time of service will not be eligible for payment. Therefore, Aetna s radiology management vendors will offer alternative providers who have been determined to be accredited in accordance with these standards. 7 of 7

8 Aetna "Select Provider" Listing - Sleep Studies FLORIDA CHARLOTTE COUNTY Port Charlotte Cornerstone Diagnostic Sleep Center* , Toledo Blade Blvd., Unit 7 Port Charlotte, FL Phone: / Fax: CITRUS COUNTY Inverness Advanced Sleep Diagnostics Center* , South Line Avenue Inverness, FL Phone: / Fax: COLLIER COUNTY Naples Total Sleep Management, Inc , th Street North Phone: / Fax: HERNANDO COUNTY Spring Hill Florida Sleep Institute , Mariner Blvd. Spring Hill, FL Phone: / Fax: Hours: M-F 9:00 am - 6:00 am - SS by appt Sleep Associates Of Florida* , Northcliffe Blvd., Suite S106 Spring Hill, FL Phone: / Fax: Hours: M-F 9:00 am - 6:00 am HILLSBOROUGH COUNTY Tampa Bay Area Sleep Associates, , West Fletcher Avenue Tampa, FL Phone: / Fax: Hours: M-F 9:00 am - 6:00 am - SS by appt Sleep Professionals of Florida , Madaca Lane Tampa, FL Phone: / Fax: SleepMed, Inc. dba Digitrace Care Services* , North Habana, Suite 302 Tampa, FL Phone: Temple Terrace CardioHealth Sleep Center of North Tampa* , Telecom Pkwy. Temple Terrace, FL Phone: / Fax: LEE COUNTY Bonita Springs Sleep Health Center* , South Tamiami Trail, Suite 2 Bonita Springs, FL Phone: / Fax: Total Sleep Management, Inc , Bonita Beach Road, Southeast, Suite 108 Bonita Springs, FL Phone: / Fax: Hours: M-F 8:00 am - 6:00 am - SS by appt Fort Myers Professional Sleep Analysis, , Bass Road, Suite 201 Fort Myers, FL Phone: / Fax: Sleep Health Center* , Palm Beach Blvd., Suite 105 Fort Myers, FL Phone: / Fax: , Riverwalk Park Blvd., Suite 201 Phone: / Fax: Sleep Management Centers, , Techster Blvd., Suite 2 Fort Myers, FL Phone: / Fax: MANATEE COUNTY Bradenton Bay Area Sleep Associates, , Carlton Arms Blvd. Bradenton, FL Phone: / Fax: Hours: M-F 9:00 am - 6:00 am - SS by appt SleepMed, Inc. dba Digitrace Care Services* , Cortez Road West, Suite 101 Bradenton, FL Phone: PASCO COUNTY New Port Richey Sleep Associates Of Florida* , Mayflower Drive New Port Richey, FL Phone: / Fax: Hours: M-F 9:00 am - 6:00 am Wesley Chapel New Tampa Sleep Center* , Windguard Circle Wesley Chapel, FL Phone: / Fax: PINELLAS COUNTY Clearwater Sleep Management* , Rio Vista Drive Clearwater, FL Phone: / Fax: Palm Harbor Bay Area Sleep Associates, , Alt 19, Suite C Palm Harbor, FL Phone: Hours: M-F 9:00 am - 6:00 am - SS by appt Sleep Management* , U.S. Hwy. 19 North Palm Harbor, FL Phone: / Fax: Pinellas Park Sleep Associates Of Florida* , th Street North, Suite 2 Phone: / Fax: Hours: M-F 9:00 am - 6:00 am POLK COUNTY Lakeland Bay Area Sleep Associates, , South Florida Avenue, Suite 3 Lakeland, FL Phone: / Fax: Hours: M-F 9:00 am - 6:00 am - SS by appt Winter Haven Bay Area Sleep Associates, , st Street South, Suite D Winter Haven, FL Phone: Hours: M-F 9:00 am - 6:00 am - SS by appt 1 of 1

9 Cypress Sleep Disorder* , Southeast Plaza Road Winter Haven, FL Phone: / Fax: Polk Sleep Disorders, LLC , East Central Avenue Winter Haven, FL Phone: / Fax: SARASOTA COUNTY Sarasota HealthSleep of Sarasota* , Cattleman Road, Suite 300 Sarasota, FL Phone: / Fax: Aetna "Select Provider" Listing - Sleep Studies 2 of 2

10 Aetna "Select Provider" Listing - Ambulatory Surgery FLORIDA CHARLOTTE COUNTY Port Charlotte Charlotte Endoscopic Surgery Center* , Suncoast Blvd. Port Charlotte, FL Phone: Hours: M-Th 6:00 to 4:30; Fri - 7:30 to 4:00, OPT Murdock Ambulatory Surgery Center, Ltd., LLP* , Education Way Port Charlotte, FL Phone: / Fax: Hours: 6:00 am - 5:00 pm M-F, ORP, ENT, Plastic, GYN Punta Gorda Harborside Surgery Center, Inc , East Olympia Avenue, Suite 100 Punta Gorda, FL Phone: Hours: M-F 6:30 am to 4:00 pm Svcs: GEN, ORP, GYN, Breast, Podiatric CITRUS COUNTY Crystal River Citrus Endoscopy & Surgery Center* , West Gulf To Lake Hwy. Crystal River, FL Phone: / Fax: Hours: M-F 7:00 am to 3:00 pm Inverness Suncoast Endoscopy Center* , East Forest Drive Inverness, FL Phone: / Fax: Hours: M-F 7:00 am to 3:30 pm COLLIER COUNTY Naples Doctors Outpatient Surgery Center , Crosspointe Drive, Suite 2 Naples, FL Phone: / Fax: Hours: M-Th 7:00 am - 5:00 pm, F 8:00 am - 4:00 pm Svcs: GEN Gulfshore Endoscopy Center, Inc.* , Goodlette Road Phone: / Fax: Hours: M-F 6:30 am - 3:00 pm Naples Day Surgery, , Health Park Blvd. Naples, FL Phone: / Fax: Hours: M-F 6:30 to 5:00 Svcs: GEN, EN, OPT, ORP , th Street North, Suite 200 Phone: / Fax: Hours: M-F 6:30 am to 5:00 pm Svcs: GEN, EN, OPT, ORP, UR Physicians Day Surgery Center, Inc.* , th Avenue North Naples, FL Phone: / Fax: Hours: M-F 6:30 am to 5:00 pm Svcs: GEN, OPT, ORP, UR Total Surgery Center* , Tamiami Trail North, Suite 210 Phone: / Fax: Hours: M-F 6:30 am - 4:30 pm Svcs: GEN , Tamiani Trail E Naples, FL Phone: Hours: M-F 6:30 am - 4:30 pm Svcs: GEN HERNANDO COUNTY Brooksville All Saints Surgery Center* , Cortez Blvd. Brooksville, FL Phone: / Fax: Hours: M-F 6:00 am - 5:00 pm Svcs: GEN, EN, OPT, ORP, UR, Gynecologic, Podiatric, Ent Florida Endoscopy and Surgery Center, , Cortez Blvd., Suite 103 Brooksville, FL Phone: Hours: M-F 8:00 am - 4:00 pm, OPT Hernando Endoscopy and Surgery Center* , Cortez Blvd. Brooksville, FL Phone: Hours: 6:30 am - 5:00 pm, OPT, ORP, UR, GYN, Podiatry, Plastic, Podiatric HIGHLANDS COUNTY Sebring NovaMed Surgery Center of Sebring, , South Highlands Avenue Sebring, FL Phone: Hours: M-Th 8:00 to 5:00; Fri 8:00 to 12:00 Svcs: GEN, EN, ORP, Pain Mgmt, Podiatry, Ent Surgical Center at Sun 'N Lake , Sun North Lake Blvd., Suite 200 Sebring, FL Phone: Svcs: GEN, EN, OPT, ORP, UR HILLSBOROUGH COUNTY Brandon Brandon Ambulatory Surgery Center, L.C.* , Eichenfeld Drive Phone: / Fax: Hours: M-F 7:00 am - 5:00 pm Svcs: GEN, EN, OPT, ORP, UR, Pain Mgmt Outpatient Surgery Center, Inc.* , Brandon Outpatient Surgery Center 201 Noland Drive, Suite B Phone: / Fax: Riverview Bay Area Physicians Surgery Center* , Winthrop Commerce Avenue, 1 Floor Riverview, FL Phone: / Fax: Hours: M-F 8:00 AM to 5:00 PM Svcs: GEN, Pain Mgmt, Ent Tampa Seascape Surgery Center, , Primrose Lake Circle Tampa, FL Phone: / Fax: Svcs: Derm & Reconstructive GEN - General Surgery EN - Endoscopy INF - Infertility LT - Lithotripsy OPT - Opthalmology ORP - Orthopedics BA - Bariatric UR - Urology 1 of 1

11 Aetna "Select Provider" Listing - Ambulatory Surgery Tampa Bay Endoscopy Center* , North Armenia Avenue, Suite 100 Tampa, FL Phone: / Fax: Hours: M-F 5:30 am - 5:00 pm Tampa Bay Surgery Center* , North Dale Mabry Hwy. Tampa, FL Phone: / Fax: Hours: M-F 6:30 am - 5:00 pm Svcs: GEN, INF, LT, OPT, ORP, UR, Pain Mgmt, Plastic, Podiatric , Martin Luther King Blvd. Tampa, FL Phone: / Fax: Hours: M-F 6:30 am to 5:00 pm Svcs: GEN, OPT, ORP, UR, Pain Mgmt, Plastic, Podiatric , Martin Luther King Blvd., Suite 100 Tampa, FL Phone: Tampa Outpatient Surgical Facility , North Armenia Avenue Tampa, FL Phone: / Fax: Svcs: GEN, INF, Plastic Tampa Surgery Center, , North Dale Mabry Hwy., Suite 100 Tampa, FL Phone: / Fax: LEE COUNTY Bonita Springs Bonita Community Health Center* , Health Center Blvd. Bonita Springs, FL Phone: Svcs: GEN, EN, OPT, ORP, ENT, Plastic, GYN Cape Coral Cape Coral Surgery Center* , Del Prado Blvd. South, Suite 100 Cape Coral, FL Phone: / Fax: Hours: M - F 8:00 am to 5:00 pm, OPT, ORP, BA, UR, Podiatric, Plastic Oral, Endo Fort Myers Barkley Surgicenter Inc , Barkley Circle, Suite 104 Fort Myers, FL Phone: / Fax: Hours: M-F 6:30 am - 5:00 pm Fort Myers Digestive Health & Pain, ASC, L.L.C , Creekside Lane, Suite 202 Phone: Hours: M-Th 8:00 am to 5:00 pm, Pain Mgmt Gulf Coast Endoscopy Center South* , Coca Sabal Lane Fort Myers, FL Phone: / Fax: Hours: M-F 7:30 am - 4:00 pm Lee Island Coast Surgery Center* , Evans Avenue Fort Myers, FL Phone: / Fax: Hours: M-F 6:00 am - 5:00 pm Svcs: GEN, EN, LT, OPT, ORP, UR, Pain Mgmt, Plastic, Podiatric Riverwalk Endoscopy and Surgery Center, LLC , Riverwalk Park Blvd., Suite 220 Phone: / Fax: Hours: M-F 6:00 am - 4:00 pm St John's Surgery Center* , Conference Drive Phone: Hours: M-F 7:00 am - 3:00 pm Svcs: OPT St. Mark's Surgical Center* , International Center Blvd. Fort Myers, FL Phone: / Fax: Suncoast Surgery Center, , New Brittany Blvd., Suite C Fort Myers, FL Phone: / Fax: Svcs: OPT SurgiCare Center* , Evans Avenue Fort Myers, FL Phone: Svcs: OPT MANATEE COUNTY Bradenton Bradenton Surgery Center , th Street West, Suite F Phone: / Fax: Manatee Surgical Center, Inc.* , Manatee Avenue West Bradenton, FL Phone: Hours: M-F 6:00 am - 5:00 pm Svcs: GEN, OPT, ORP, UR, Pain Mgmt; Plastic, Onc, Neuro, Podiatric West Florida Surgery Center, Inc.* , st Avenue West Phone: / Fax: Hours: M W Th Fri 8:00 to 5:00 Svcs: GEN PASCO COUNTY Holiday Holiday Surgery Center , U.s. Hwy. 19, Suite B Holiday, FL Phone: Hours: M-F 7:30 am - 4:00 pm Svcs: OPT New Port Richey Bardmoor Outpatient Center* , Trinity Oaks Blvd. New Port Richey, FL Phone: Hours: M-F 8:00 pm to 5:00 am Svcs: GEN, OPT, ORP, UR, Ent, Pain Mgmt, Podiatric, Plastic, GYN Meadow Lane Surgery Center , Meadowlane Street, Suite A New Port Richey, FL Phone: Hours: M-F 7:00 am to 5:00 pm Svcs: ORP, Podriatric, Pain Mgmt Seven Springs Surgery Center , Seven Springs Blvd. New Port Richey, FL Phone: / Fax: Hours: M-F 7:00 am - 5:00 pm, OPT, Pain Mgmt, Plastic GEN - General Surgery EN - Endoscopy INF - Infertility LT - Lithotripsy OPT - Opthalmology ORP - Orthopedics BA - Bariatric UR - Urology 2 of 2

12 Aetna "Select Provider" Listing - Ambulatory Surgery Trinity Surgery Center, L.L.C.* , Trinity Oaks Blvd New Port Richey, FL Phone: / Fax: Hours: M-F 6:00 am - 4:00 pm Svcs: GEN, EN, OPT, ORP, UR, Pain Mgmt; Plastic, Gyn, ENT, Podiatric Zephyrhills Same Day Surgery Center* , Gall Blvd. Zephyrhills, FL Phone: / Fax: Svcs: OPT PINELLAS COUNTY Clearwater Clearwater Endoscopy Center* , Corbett Street, Suite 220 Clearwater, FL Phone: / Fax: Hours: M-F 7:00 am - 3:00 pm C-Med Ambulatory Surgery Center* , Drew Street Clearwater, FL Phone: / Fax: Svcs: Pain Mgmt Safety Harbor Surgery Center* 3280 North McMullen Booth Clearwater, FL Phone: / Fax: Hours: M-F 7:00 am 5:00 pm Svcs: GEN, OPT, ORP, GE West Coast Endoscopy Center* , E Street Clearwater, FL Phone: / Fax: Hours: M-F 7:00 am - 4:00 pm Largo Bardmoor Outpatient Center* , Bryan Dairy Road Largo, FL Phone: / Fax: Hours: M-F 6:00 am - 6:00 pm Svcs: GEN, EN, OPT, ORP, UR, Pain Mgmt, Plastic, Podiatric Largo Ambulatory Surgery Center, L.L.C.* , th Street Southwest Largo, FL Phone: / Fax: Hours: M-F 6:30 am to 5:00 pm Svcs: OPT Largo Endoscopy Ctr dba Tampa Bay Reg. Surg Ctr* , Bryan Dairy Road, Suite 495 Largo, FL Phone: / Fax: Hours: M-F 7:00 am - 5:00 pm Svcs: GEN, EN, Plastic, Podiatric West Bay Surgery Center* , West Bay Drive Largo, FL Phone: / Fax: Hours: M-F 6:00 am - 5:00 pm Svcs: GEN, EN, OPT, ORP, UR, Gynecologic, Plastic, Podiatric Pinellas Park Tampa Bay Specialty Surgery Center, , th Street Phone: / Fax: Hours: M-F 6:00 am to 5:00 pm Svcs: GEN, EN, ORP, UR, Pain Mgmt, Gyn West Park Surgery Center, , th Avenue, Suite B Phone: / Fax: Hours: M-F 6:30 am - 5:00 pm Svcs: GEN, EN, OPT, ORP, UR St. Petersburg Bay Area Endoscopy and Surgery Center , th Street North St. Petersburg, FL Phone: Hours: M-F 6:30 am - 5:00 pm Bayfront Same Day Surgery Center , th Street South, 2nd Floor St. Petersburg, FL Phone: Hours: M-F 6:30 am - 4:30 pm Svcs: GEN, EN, INF, OPT, ORP, UR, Plastic, Ent Carillon Surgery Center, , Carillon Pkwy. St. Petersburg, FL Phone: / Fax: Hours: M- F 8:00 am - 5:00 pm Svcs: GEN, EN, ORP, UR, Plastic, Pain Mgmt, Pasadena Surgery Center, L.L.C* , st Avenue South St. Petersburg, FL Phone: Hours: M-F 8:00 a.m. - 5:00 p.m. Svcs: GEN, OPT, ORP St. Anthony's Physician Surgery Center* , th Street North St. Petersburg, FL Phone: / Fax: Hours: M-F 6:30-5:00 pm Svcs: GEN, EN, OPT, ORP, BA, UR, GYN POLK COUNTY Lakeland Lakeland Surgical and Diagnostic Center, LLP* , North Florida Avenue Lakeland, FL Phone: Hours: M-F 7:00 am to 7:00 pm Svcs: GEN, EN, OPT, ORP, UR, Breast; GYN; Pain Mgmt; Plastic Surg; Podiatric , Griffin Road Lakeland, FL Phone: / Fax: Hours: M-F 7:00 am to 7:00 pm Svcs: GEN, EN, OPT, ORP, UR, Breast; GYN; Pain Mgmt; Plastic Surg; Podiatric Surgery Center of Lakeland Hills Blvd.* , Lakeland Hills Blvd. Lakeland, FL Phone: / Fax: Hours: M-F 6:00 am - 5:00 pm Winter Haven Winter Haven Ambulatory Surgical Center, L.L.C.* , Avenue B Northwest Winter Haven, FL Phone: Svcs: GEN, EN, LT, ORP, UR, Gynecologic, Plastic, Podiatric, Pain Mgmt, Neuro SARASOTA COUNTY Englewood Gulf Comprehensive Surgery Center* , Englewood Road Englewood, FL Phone: / Fax: Hours: M-F 7:00 am - 4:00 pm Sarasota Aescuiapian Surgery Center, , Cattlemen Road, Suite 100 Sarasota, FL Phone: / Fax: Hours: M-F 6:00 am - 5:00 pm Svcs: GEN, EN, ORP, UR, Pain Mgmt, Plastic, Podiatric, Ent GEN - General Surgery EN - Endoscopy INF - Infertility LT - Lithotripsy OPT - Opthalmology ORP - Orthopedics BA - Bariatric UR - Urology 3 of 3

13 Aetna "Select Provider" Listing - Ambulatory Surgery Cape Surgery Center , Waldemere Street Sarasota, FL Phone: Hours: M-F 6:30 am - 5:00 pm Svcs: GEN, EN, LT, OPT, ORP, BA, UR, Pain Mgmt Center for Endoscopy, Inc , Tamiami Trail, Suite 100 Sarasota, FL Phone: / Fax: Hours: M-F 7:00 am - 5:00 pm Coastal Medical Center , South School Avenue Sarasota, FL Phone: / Fax: Hours: M-F 6:30 am - 4:30 pm Svcs: LT, UR Laser & Surgical Services at Center for Sight, , South Tamiami Trail Sarasota, FL Phone: / Fax: Svcs: OPT, Plastic, Derm Sarasota Physicians Surgical Center, , South Tamiami Trail Sarasota, FL Phone: / Fax: Hours: M-F 6:00 am to 5:00 pm Svcs: Ent, Plastic, Podiatic Venice Center of Surgical Excellence* , Pointe Loop Drive Venice, FL Phone: / Fax: Hours: M-F 7:00 am to 4:00 pm, Pain Mgmt Gulf Coast Endoscopy Center of Venice, , East Venice Avenue Venice, FL Phone: / Fax: Hours: M-F 7:30 am - 5:00 pm 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 4 of 4