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General NPI Number Information
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NPI Number | 1780941864
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Entity Type | Organization
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Legal Business Name | IMPRESSION IMAGING LLC
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Dates
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Enumeration Date | 04/13/2012
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 7180 N UNIVERSITY DR
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City | TAMARAC
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State | FL
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Zip | 33321-2916
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Country | US
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Telephone | 954-580-2780
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Fax |
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Provider Business Mailing Address
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Address Line | 7180 N UNIVERSITY DR
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City | TAMARAC
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State | FL
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Zip | 33321-2916
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Country | US
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Telephone | 954-580-2780
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | MICHAEL FAGIEN
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Credential | MD
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Telephone | 954-580-2780
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2085N0904X
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Taxonomy Name | Nuclear Radiology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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