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Organization
PROFESSIONAL DIAGNOSTIC READING MRI INC.
Active
Organization
PROFESSIONAL DIAGNOSTIC READING MRI INC.
Active
Other names
Advanced MRI Diagnostics
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE VIVAS (CFO)
(904) 399-2500
Entity
Organization
Contact information
Practice address
3728 PHILLIPS HWY, STE34, JACKSONVILLE, FL 32207-9300
(904) 399-2500
(904) 399-2495
Mailing address
3728 PHILLIPS HWY, STE34, JACKSONVILLE, FL 32207-9300
(904) 399-2500
(904) 399-2495
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
1000032322
FL
261QR0200X
Radiology Clinic/Center
1000032322
FL
Other
Enumeration date
07/14/2011
Last updated
02/27/2013
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