Organization
OPEN MRI & DIAGNOSTIC IMAGING, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORENZO S BONGOLAN M.D. (PRESIDENT)
(305) 354-7008
Entity
Organization
Contact information
Practice address
16401 NW 2ND AVE, SUITE 103, NORTH MIAMI BEACH, FL 33169-6036
(305) 354-7008
(305) 354-7091
Mailing address
16401 NW 2ND AVE, SUITE 103, NORTH MIAMI BEACH, FL 33169-6036
(305) 354-7008
(305) 354-7091
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
HCCR1337
FL
Other
Enumeration date
09/13/2006
Last updated
08/22/2020
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