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General NPI Number Information
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NPI Number | 1760579411
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Entity Type | Organization
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Legal Business Name | CENTRAL FLORIDA OPEN MRI INC
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 01/13/2012
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Provider Practice Location Address
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Address Line | 2821 US HWY 27 NORTH
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City | SEBRING
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State | FL
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Zip | 33870-1626
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Country | US
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Telephone | 863-402-0938
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Fax | 863-402-0946
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Provider Business Mailing Address
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Address Line | 2821 US HWY 27 NORTH
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City | SEBRING
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State | FL
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Zip | 33870-1626
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Country | US
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Telephone | 863-402-0938
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Fax | 863-402-0946
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Authorized Official
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Title or Position | PRESIDENT
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Name | FABIO OLIVEROS
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Credential |
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Telephone | 863-385-2606
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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 |
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License Number State | FL
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