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General NPI Number Information
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NPI Number | 1689499865
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Entity Type | Organization
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Legal Business Name | MARC IMAGING GROUP LLC
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Dates
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Enumeration Date | 11/21/2024
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Last Update Date | 11/21/2024
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Provider Practice Location Address
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Address Line | 15528 W COLONIAL DR STE A
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City | WINTER GARDEN
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State | FL
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Zip | 34787-9567
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Country | US
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Telephone | 407-674-9600
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Fax | 407-557-9404
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Provider Business Mailing Address
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Address Line | 155528 WEST COLONIAL DRIVE BUILDING F/SUITE A
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City | WINTER GARDEN
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State | FL
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Zip | 34787
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Country | US
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Telephone | 407-674-9600
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Fax | 407-557-9404
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. CARL LEE ERICKSON
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Credential | RT (R)(MR)
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Telephone | 407-312-5384
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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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