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General NPI Number Information
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NPI Number | 1558391540
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Entity Type | Organization
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Legal Business Name | MOBILE SONIX LLC
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 02/07/2012
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Provider Practice Location Address
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Address Line | 13059 PENSHURST LN
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City | WINDERMERE
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State | FL
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Zip | 34786-6671
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Country | US
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Telephone | 407-339-7717
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Fax | 321-445-5559
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Provider Business Mailing Address
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Address Line | PO BOX 947951
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City | MAITLAND
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State | FL
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Zip | 32794-7951
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Country | US
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Telephone | 407-339-7717
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Fax | 321-445-5559
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MRS. JENNIFER J FOX
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Credential |
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Telephone | 407-339-7717
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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 | HCC7053
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License Number State | FL
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