Healthcare Provider Details

I. General information

NPI: 1174610828
Provider Name (Legal Business Name): SELECT OPEN MRI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8462 NORTHCLIFFE BLVD
SPRING HILL FL
34606
US

IV. Provider business mailing address

8462 NORTHCLIFFE BLVD
SPRING HILL FL
34606
US

V. Phone/Fax

Practice location:
  • Phone: 352-688-7377
  • Fax: 352-688-2644
Mailing address:
  • Phone: 352-688-7377
  • Fax: 352-688-2644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247100000X
TaxonomyRadiologic Technologist
License Number
License Number State

VIII. Authorized Official

Name: MR. EMIL SCOTT STUERMER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 352-688-7377