Organization
SAN JOSE IMAGING CENTER LLC
Active
Other names
Innovative Imaging Jacksonville
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL STANLEY (CEO)
(813) 690-5720
Entity
Organization
Contact information
Practice address
10696 OLD SAINT AUGUSTINE RD, JACKSONVILLE, FL 32257-1000
(904) 268-1080
(904) 268-3060
Mailing address
PO BOX 270543, TAMPA, FL 33688-0543
(850) 478-1312
(850) 474-9060
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Enumeration date
10/05/2007
Last updated
10/05/2020
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