Organization
HOMOSASSA OPEN MRI INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN P STAGG CEO (CHIEF EXECUTIVE OFFICER)
(225) 270-7077
Entity
Organization
Contact information
Practice address
8464 W AQUADUCT ST, HOMOSASSA, FL 34448-2724
(888) 273-3445
(352) 628-4801
Mailing address
4241 VETERANS MEMORIAL BLVD STE 200, METAIRIE, LA 70006-5430
(888) 273-3344
(504) 883-5384
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
261QM1200X
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
030734300
—
FL
Enumeration date
10/16/2006
Last updated
12/02/2022
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