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General NPI Number Information
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NPI Number | 1033300330
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL IMAGING CENTERS INC
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Dates
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Enumeration Date | 08/05/2007
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Last Update Date | 06/08/2009
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Provider Practice Location Address
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Address Line | 911 E OAK STREET SUITE A
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City | KISSIMMEE
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State | FL
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Zip | 34744-5836
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Country | US
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Telephone | 407-847-3070
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Fax | 407-678-9938
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Provider Business Mailing Address
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Address Line | 911 E OAK ST STE A
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City | KISSIMMEE
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State | FL
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Zip | 34744-5836
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Country | US
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Telephone | 407-847-3070
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Fax | 407-847-2723
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Authorized Official
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Title or Position | ADMINISTRATOR/CFO
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Name | MR. EDWIN MEJIAS
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Credential |
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Telephone | 407-657-7979
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | HCC7787
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License Number State | FL
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