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General NPI Number Information
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NPI Number | 1093783292
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Entity Type | Organization
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Legal Business Name | OPEN MRI OF OKEECHOBEE LLC
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Dates
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Enumeration Date | 03/14/2006
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Last Update Date | 03/19/2008
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Provider Practice Location Address
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Address Line | 115 NE 3RD ST SUITE A
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City | OKEECHOBEE
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State | FL
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Zip | 34972-2944
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Country | US
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Telephone | 863-824-6736
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Fax | 863-824-6737
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Provider Business Mailing Address
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Address Line | 115 NE 3RD ST SUITE A
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City | OKEECHOBEE
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State | FL
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Zip | 34972-2944
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Country | US
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Telephone | 863-824-6736
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Fax | 863-824-6737
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Authorized Official
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Title or Position | INSURANCE BILLING SPECIALIST
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Name | MS. LINDA M MOODY
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Credential |
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Telephone | 863-824-6736
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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