MEDICARE: OPEN MRI OF FLORIDA, LTD

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
1	2085R0202X	Diagnostic Radiology Physician

General Provider Information

NPI Number	:	1821286881
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPEN MRI OF FLORIDA, LTD

Provider Business Mailing Address
First Line	:	3733 PARK EAST DR
Second Line	:	SUITE 100
City	:	BEACHWOOD
State	:	OH
Zip	:	44122-4338
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6161 SUNSET DR
Second Line	:
City	:	SOUTH MIAMI
State	:	FL
Zip	:	33143-5045
Country	:	US
Telephone Number	:	305-661-6445
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	NANCY WESTRICH
Credential	:
Telephone Number	:	216-292-9998

Provider Enumeration Date	:	10/04/2007
Last Update Date	:	10/04/2007

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