Healthcare Provider Details

I. General information

NPI: 1619909686
Provider Name (Legal Business Name): EIBER RADIOLOGY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 11/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5210 BELFORT RD SUITE 130
JACKSONVILLE FL
32256-6024
US

IV. Provider business mailing address

5210 BELFORT RD SUITE 130
JACKSONVILLE FL
32256-6024
US

V. Phone/Fax

Practice location:
  • Phone: 904-281-7600
  • Fax: 904-281-7601
Mailing address:
  • Phone: 904-281-7600
  • Fax: 904-281-7601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number State

VIII. Authorized Official

Name: ALBERTO M EIBER
Title or Position: PRESIDENT
Credential: MD
Phone: 305-557-0330