Organization
JACKSONVILLE MOBILE IMAGING SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID JOHNSON RT. NMT. (PRESIDENT)
(904) 545-3591
Entity
Organization
Contact information
Practice address
4237 SALISBURY RD, SUITE 306, JACKSONVILLE, FL 32216-8029
(904) 296-0353
(904) 296-9403
Mailing address
4237 SALISBURY RD, SUITE 306, JACKSONVILLE, FL 32216-8029
(904) 296-0353
(904) 296-9403
Taxonomy
Speciality
Code
Description
License number
State
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
HCC3853
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
606011
PRINCIPAL
FL
01
—
PIN#1365 102533
AVMED
FL
Enumeration date
07/08/2005
Last updated
04/15/2008
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