Healthcare Provider Details

I. General information

NPI: 1457273260
Provider Name (Legal Business Name): MOBILE NUCLEAR IMAGING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4566 NW 5TH BLVD STE M
GAINESVILLE FL
32609-0807
US

IV. Provider business mailing address

4566 NW 5TH BLVD STE M
GAINESVILLE FL
32609-0807
US

V. Phone/Fax

Practice location:
  • Phone: 818-268-9742
  • Fax:
Mailing address:
  • Phone: 818-268-9742
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0208X
TaxonomyMobile Radiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JASMIN Y GOSEN
Title or Position: OWNER/PHYSICIAN
Credential: MD
Phone: 818-268-9742