Healthcare Provider Details

I. General information

NPI: 1366738767
Provider Name (Legal Business Name): FLORIDA MRI & IMAGING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2011
Last Update Date: 12/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 S FLAMINGO RD
PEMBROKE PINES FL
33027-1770
US

IV. Provider business mailing address

330 S FLAMINGO RD
PEMBROKE PINES FL
33027-1770
US

V. Phone/Fax

Practice location:
  • Phone: 954-874-7988
  • Fax: 954-874-7989
Mailing address:
  • Phone: 954-874-7988
  • Fax: 954-874-7989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2471C3401X
TaxonomyComputed Tomography Radiologic Technologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2471C3402X
TaxonomyRadiography Radiologic Technologist
License Number
License Number State

VIII. Authorized Official

Name: MR. FRANCISCO MARTINEZ
Title or Position: OWNER PRESIDENT
Credential:
Phone: 954-874-7988