Organization
ADVANCED MOLECULAR IMAGING OF FLORIDA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL FAGIEN MD (CEO)
(954) 557-8408
Entity
Organization
Contact information
Practice address
2650 N MILITARY TRL, BOCA RATON, FL 33431-6350
(954) 557-8408
Mailing address
2650 N MILITARY TRL, BOCA RATON, FL 33431-6350
(954) 557-8408
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
ME59548
FL
2085D0003X
Diagnostic Neuroimaging (Radiology) Physician
ME59548
FL
2085R0202X
Diagnostic Radiology Physician
ME59548
FL
261Q00000X
Clinic/Center
ME59548
FL
261QR0200X
Radiology Clinic/Center
Primary
ME59548
FL
Other
Enumeration date
04/09/2008
Last updated
04/09/2008
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