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General NPI Number Information
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NPI Number | 1235237355
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Entity Type | Organization
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Legal Business Name | MRI SCAN CENTER LLC
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 06/04/2025
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Provider Practice Location Address
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Address Line | 3122 E COMMERCIAL BLVD
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City | FORT LAUDERDALE
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State | FL
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Zip | 33308-4327
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Country | US
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Telephone | 954-772-8000
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Fax | 954-776-6356
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Provider Business Mailing Address
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Address Line | 3122 E COMMERCIAL BLVD
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City | FORT LAUDERDALE
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State | FL
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Zip | 33308-4327
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Country | US
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Telephone | 954-772-8000
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Fax | 954-776-6356
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Authorized Official
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Title or Position | COMPLIANCE OFFICER
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Name | LAURA KASSA
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Credential | RT (R)(CT)(MR)
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Telephone | 904-640-9129
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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 | 2790004383
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License Number State | FL
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