Organization
JACKSONVILLE MOBILE IMAGING SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID JOHNSON RT.,NMT (PRESIDENT)
(904) 296-0353
Entity
Organization
Contact information
Practice address
4237 SALISBURY RD, SUITE 306, JACKSONVILLE, FL 32216-8029
(904) 296-0353
(904) 296-9403
Mailing address
4237 SALISBURY RD, SUITE 306, JACKSONVILLE, FL 32216-8029
(904) 296-0353
(904) 296-9403
Taxonomy
Speciality
Code
Description
License number
State
261QR0208X
Mobile Radiology Clinic/Center
HCC3853
FL
293D00000X
Physiological Laboratory
Primary
HCC3853
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
606011
PRINCIPAL
FL
01
—
630000562
RAILROAD MEDICARE
FL
01
—
PIN#1365 102533
AVMED
FL
Enumeration date
07/26/2006
Last updated
02/12/2013
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