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NPI Code Detail

MEDICARE: PRESGAR IMAGING OF DAYTONA, LLLP

MEDICARE: PRESGAR IMAGING OF DAYTONA, LLLP
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
1261QM1200XMagnetic Resonance Imaging (MRI) Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1881904902
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRESGAR IMAGING OF DAYTONA, LLLP
Provider Business Mailing Address
First Line : 6415 LAKE WORTH RD STE 102
Second Line :
City : GREENACRES
State : FL
Zip : 33463-3009
Country : US
Telephone Number : 561-331-0808
Fax Number : 561-237-6034
Provider Business Practice Location Address
First Line : 201 BILL FRANCE BLVD
Second Line :
City : DAYTONA BEACH
State : FL
Zip : 32114-1316
Country : US
Telephone Number : 386-254-6800
Fax Number : 386-254-6995
Authorized Official
Title or Position : PRESIDENT AND CEO
Name : MR. GARY W. WRIGHT
Credential :
Telephone Number : 813-675-2600
Provider Enumeration Date : 10/08/2010
Last Update Date : 03/27/2020

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Directions to “PRESGAR IMAGING OF DAYTONA, LLLP ” Practice Location

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