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General NPI Number Information
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NPI Number | 1801396742
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Entity Type | Organization
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Legal Business Name | FT. MYERS MRI, LLC
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Dates
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Enumeration Date | 02/16/2018
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Last Update Date | 02/16/2018
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Provider Practice Location Address
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Address Line | 6300 CORPORATE CT STE 101
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City | FORT MYERS
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State | FL
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Zip | 33919-3513
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Country | US
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Telephone | 239-689-3695
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Fax |
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Provider Business Mailing Address
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Address Line | 6300 CORPORATE CT STE 101
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City | FORT MYERS
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State | FL
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Zip | 33919-3513
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Country | US
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Telephone | 239-689-3695
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Fax |
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Authorized Official
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Title or Position | REGISTERED AGENT
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Name | MODESTO SANCHEZ-TORRES
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Credential | MD
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Telephone | 239-689-3695
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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 | FL
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