Organization
WEST BOYNTON BEACH OPEN IMAGING CENTER LLC
Active
Organization
WEST BOYNTON BEACH OPEN IMAGING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WANDA FOGARTY (VP IMAGING SERVICES)
(561) 838-3630
Entity
Organization
Contact information
Practice address
10151 ENTERPRISE CENTER BLVD, SUITE 109, BOYNTON BEACH, FL 33437-3759
(561) 752-5050
(561) 364-5606
Mailing address
10151 ENTERPRISE CENTER BLVD, SUITE 109, BOYNTON BEACH, FL 33437-3759
(561) 752-5050
(561) 364-5606
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000260600
—
FL
01
—
V3267
BCBS OF FL
FL
Enumeration date
02/12/2008
Last updated
05/18/2010
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