MEDICARE: IMPRESSION IMAGING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician

General Provider Information

NPI Number	:	1104637537
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IMPRESSION IMAGING LLC

Provider Business Mailing Address
First Line	:	PO BOX 21422
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10087-1422
Country	:	US
Telephone Number	:	347-577-9062
Fax Number	:

Provider Business Practice Location Address
First Line	:	3111 N UNIVERSITY DR STE 115
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33065-5049
Country	:	US
Telephone Number	:	954-580-2780
Fax Number	:	954-580-2790

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	MICHAEL FAGIEN
Credential	:	MD
Telephone Number	:	954-580-2780

Provider Enumeration Date	:	01/15/2025
Last Update Date	:	01/15/2025

Similar Medicare Providers

1285609453 — DR. HOWARD PHILIP SILVERBOARD M.D.
Practice Location Address:

5673 PEACHTREE DUNWOODY RD STE 950
SANDY SPRINGS, GA
30342-5049

Practice Phone: 404-256-3135
Practice Fax: 404-256-3137

1609995414 — LILY RAMPHAL MD
Practice Location Address:

3220 KELLER SPRINGS RD , SUITE 106
CARROLLTON, TX
75006-5049

Practice Phone: 615-778-4066
Practice Fax: 615-778-9114

1619791266 — ELIZABETH SPARKS
Practice Location Address:

5049 LONZO DR
COLORADO SPRINGS, CO
80924-5352

Practice Phone: 719-205-9895
Practice Fax:

1336966910 — FLORIDA EM-I MEDICAL SERVICES, PA
Practice Location Address:

3000 CORAL HILLS DR
CORAL SPRINGS, FL
33065-4108

Practice Phone: 954-939-5000
Practice Fax: 877-250-6889

1871542969 — PHOENIX EMERGENCY MEDICINE OF BROWARD LLC
Practice Location Address:

3000 CORAL HILLS DR
CORAL SPRINGS, FL
33065-4108

Practice Phone: 954-939-5000
Practice Fax: 877-250-6889

1508815655 — PHOENIX PEDIATRICS OF BROWARD LLC
Practice Location Address:

3000 CORAL HILLS DR
CORAL SPRINGS, FL
33065-4108

Practice Phone: 954-939-5000
Practice Fax: 877-250-6889

Directions to “IMPRESSION IMAGING LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.