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General NPI Number Information
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NPI Number | 1912682667
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Entity Type | Organization
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Legal Business Name | TESLA MRI LLC
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Dates
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Enumeration Date | 06/20/2023
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Last Update Date | 06/20/2023
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Provider Practice Location Address
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Address Line | 2215 WINKLER AVE STE G
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City | FORT MYERS
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State | FL
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Zip | 33901-9150
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Country | US
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Telephone | 833-837-5267
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Fax | 888-385-6488
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Provider Business Mailing Address
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Address Line | 3350 NW BOCA RATON BLVD STE B10
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City | BOCA RATON
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State | FL
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Zip | 33431-6636
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Country | US
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Telephone | 883-837-5267
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Fax | 888-385-6488
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Authorized Official
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Title or Position | COO
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Name | MR. ALVARO VIRGUETTY
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Credential |
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Telephone | 561-715-4689
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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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