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NPI Code Detail

MEDICARE: OPEN MRI OF DELRAY LLC

MEDICARE: OPEN MRI OF DELRAY LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM1200XMagnetic Resonance Imaging (MRI) Clinic/CenterHCC4286FL

General Provider Information

NPI Number : 1003804816
Entity Type Code : Organization
Provider Name (Legal Business Name) : OPEN MRI OF DELRAY LLC
Provider Business Mailing Address
First Line : 15127 JOG RD
Second Line : SUITE 101
City : DELRAY BEACH
State : FL
Zip : 33446-1251
Country : US
Telephone Number : 561-381-5164
Fax Number : 561-381-5165
Provider Business Practice Location Address
First Line : 15127 JOG RD
Second Line : SUITE 101
City : DELRAY BEACH
State : FL
Zip : 33446-1251
Country : US
Telephone Number : 561-381-5164
Fax Number : 561-381-5165
Authorized Official
Title or Position : OWNER
Name : MR. JOSEPH LHOTKA
Credential :
Telephone Number : 561-381-5164
Provider Enumeration Date : 10/06/2005
Last Update Date : 01/14/2009

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