Healthcare Provider Details

I. General information

NPI: 1477915031
Provider Name (Legal Business Name): MRI ASSOCIATES OF VENICE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2016
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1370 E VENICE AVE STE 101
VENICE FL
34285-9083
US

IV. Provider business mailing address

1370 E VENICE AVE SUITE 101
VENICE FL
34285-9082
US

V. Phone/Fax

Practice location:
  • Phone: 941-484-6500
  • Fax: 941-484-6556
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License NumberHCC9091
License Number StateFL

VIII. Authorized Official

Name: AMANDA MAPLE
Title or Position: CAO
Credential:
Phone: 727-787-6900