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General NPI Number Information
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NPI Number | 1245236678
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Entity Type | Organization
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Legal Business Name | PALM BEACH REGIONAL MRI INC
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Dates
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Enumeration Date | 06/21/2005
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Last Update Date | 11/22/2018
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Provider Practice Location Address
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Address Line | 701 NORTHLAKE BLVD STE 106
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City | NORTH PALM BEACH
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State | FL
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Zip | 33408-5215
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Country | US
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Telephone | 561-882-0674
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Fax | 561-882-4141
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Provider Business Mailing Address
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Address Line | 173 MAIN ST
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City | THOMASTON
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State | ME
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Zip | 04861-3807
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Country | US
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Telephone | 561-882-0674
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Fax | 561-882-4141
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MR. MARTIN J FARRELL
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Credential |
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Telephone | 207-706-6810
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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 |
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License Number State |
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