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Organization
BEACHES OPEN MRI, LLC
Active
Organization
BEACHES OPEN MRI, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK S. FRISK M.D. (RADIOLOGIST)
(904) 247-2220
Entity
Organization
Contact information
Practice address
350 10TH AVE S, JACKSONVILLE BEACH, FL 32250-5136
(904) 247-2220
(904) 247-2296
Mailing address
350 10TH AVE S, JACKSONVILLE BEACH, FL 32250-5136
(904) 247-2220
(904) 247-2296
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
0700012919
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2240835
AETNA PROVIDER #
FL
01
—
38350
WELLCARE
FL
01
—
V2353
BCBS PROVIDER #
FL
Enumeration date
01/17/2007
Last updated
01/24/2012
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