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Organization

CLEVELAND RADIOLOGY CENTER INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MARIO FONSECA (GENERAL MANAGER)
(305) 775-9986
Entity
Organization

Contact information

Practice address
12995 S CLEVELAND AVE STE 182, FORT MYERS, FL 33907-7719
(305) 775-9986
Mailing address
12995 S CLEVELAND AVE STE 182, FORT MYERS, FL 33907-7719
(305) 775-9986

Taxonomy

Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
261QR0200X
Radiology Clinic/Center

Other

Enumeration date
06/02/2010
Last updated
06/10/2010
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