MEDICARE: ABSOLUTE IMAGING NETWORK,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	247100000X	Radiologic Technologist	1000006568	FL

General Provider Information

NPI Number	:	1972793289
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABSOLUTE IMAGING NETWORK,LLC.

Provider Business Mailing Address
First Line	:	6999 MERRILL RD STE 2
Second Line	:	BOX 305
City	:	JACKSONVILLE
State	:	FL
Zip	:	32277-2690
Country	:	US
Telephone Number	:	904-743-2222
Fax Number	:

Provider Business Practice Location Address
First Line	:	6919 MERRILL RD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32277-2616
Country	:	US
Telephone Number	:	904-743-2222
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. FIAZ A JALEEL
Credential	:	M.D.
Telephone Number	:	904-743-2222

Provider Enumeration Date	:	08/01/2007
Last Update Date	:	08/01/2007

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