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General NPI Number Information
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NPI Number | 1780157453
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Entity Type | Organization
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Legal Business Name | OPEN MAGNETIC SCANNING OF BOCA DELRAY
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Dates
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Enumeration Date | 01/06/2019
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Last Update Date | 01/06/2019
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Provider Practice Location Address
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Address Line | 14590 S MILITARY TRL STE E12
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City | DELRAY BEACH
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State | FL
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Zip | 33484-3755
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Country | US
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Telephone | 954-290-2793
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Fax |
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Provider Business Mailing Address
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Address Line | 4805 N DIXIE HWY
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City | OAKLAND PARK
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State | FL
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Zip | 33334-3928
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. SCOTT NEVINS WINDSOR
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Credential |
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Telephone | 954-290-2793
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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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