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General NPI Number Information
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NPI Number | 1982909123
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL IMAGING CENTERS INC
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Dates
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Enumeration Date | 01/19/2011
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Last Update Date | 07/17/2014
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Provider Practice Location Address
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Address Line | 225 W SR 434 SUITE 104
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City | LONGWOOD
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State | FL
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Zip | 32750-4980
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Country | US
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Telephone | 407-301-1000
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Fax | 407-678-9938
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Provider Business Mailing Address
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Address Line | 1049 WILLA SPRINGS DR SUITE 1051
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City | WINTER SPRINGS
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State | FL
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Zip | 32708-5246
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Country | US
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Telephone | 407-657-7979
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Fax | 407-678-9938
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Authorized Official
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Title or Position | CFO
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Name | MR. EDWIN MEJIAS
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Credential |
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Telephone | 407-493-3979
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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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Taxonomy #2
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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