MEDICARE: MEDICAL CENTER IMAGING, 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
1	174400000X	Specialist	CH5626	FL

General Provider Information

NPI Number	:	1881627206
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL CENTER IMAGING, LLC

Provider Business Mailing Address
First Line	:	4623 FOREST HILL BLVD
Second Line	:	SUITE 110
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33415-9120
Country	:	US
Telephone Number	:	561-966-7194
Fax Number	:	561-966-7191

Provider Business Practice Location Address
First Line	:	4623 FOREST HILL BLVD
Second Line	:	SUITE 110
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33415-9121
Country	:	US
Telephone Number	:	561-296-9988
Fax Number	:	561-967-4944

Authorized Official
Title or Position	:	CEO/PRESIDENT
Name	:	DR. RUSS M SEGER
Credential	:	DC
Telephone Number	:	561-967-8888

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	01/11/2017

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