MEDICARE: A1 IMAGING OF CORAL GABLES 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	261QM1200X	Magnetic Resonance Imaging (MRI) Clinic/Center

General Provider Information

NPI Number	:	1740438092
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A1 IMAGING OF CORAL GABLES LLC

Provider Business Mailing Address
First Line	:	2 N. TAMIAMI TRAIL
Second Line	:	SUITE 800
City	:	SARASOTA
State	:	FL
Zip	:	34236-5559
Country	:	US
Telephone Number	:	941-925-3490
Fax Number	:	941-953-4452

Provider Business Practice Location Address
First Line	:	2000 PONCE DE LEON BLVD
Second Line	:	SUITE 102
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-4422
Country	:	US
Telephone Number	:	941-925-3490
Fax Number	:

Authorized Official
Title or Position	:	SENIOR VICE PRESIDENT
Name	:	ALAN BABITZ
Credential	:
Telephone Number	:	941-925-3490

Provider Enumeration Date	:	08/28/2008
Last Update Date	:	08/28/2008

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