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General NPI Number Information
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NPI Number | 1003804816
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Entity Type | Organization
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Legal Business Name | OPEN MRI OF DELRAY LLC
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Dates
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Enumeration Date | 10/06/2005
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Last Update Date | 01/14/2009
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Provider Practice Location Address
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Address Line | 15127 JOG RD SUITE 101
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City | DELRAY BEACH
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State | FL
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Zip | 33446-1251
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Country | US
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Telephone | 561-381-5164
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Fax | 561-381-5165
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Provider Business Mailing Address
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Address Line | 15127 JOG RD SUITE 101
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City | DELRAY BEACH
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State | FL
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Zip | 33446-1251
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Country | US
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Telephone | 561-381-5164
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Fax | 561-381-5165
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Authorized Official
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Title or Position | OWNER
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Name | MR. JOSEPH LHOTKA
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Credential |
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Telephone | 561-381-5164
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
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License Number | HCC4286
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License Number State | FL
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