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General NPI Number Information
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NPI Number | 1922916006
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Entity Type | Organization
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Legal Business Name | AMBROSE RADIOLOGY AND PSYCHOLOGY SERVICES LLC
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Dates
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Enumeration Date | 08/31/2026
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Last Update Date | 08/31/2026
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Provider Practice Location Address
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Address Line | 505 UPPER LOVENLUND GNS MAHOGANY RUN
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City | ST. THOMAS
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State | VI
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Zip | 00802
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Country | US
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Telephone | 615-484-6892
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 600205
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City | ST THOMAS
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State | VI
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Zip | 00801-6205
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Country | US
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Telephone | 615-484-6892
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Fax |
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Authorized Official
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Title or Position | RADIOLOGIST
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Name | DR. MAHOGANY JERVON AMBROSE
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Credential | MD
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Telephone | 615-484-6892
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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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 | 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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