Organization
ASCENT DIAGNOSTIC IMAGING OF JACKSONVILLE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL FAGIEN MD (COO)
(813) 496-1075
Entity
Organization
Contact information
Practice address
5210 BELFORT RD, STE 130, JACKSONVILLE, FL 32256-6024
(904) 470-4000
Mailing address
5210 BELFORT RD, STE 130, JACKSONVILLE, FL 32256-6024
(904) 470-4000
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
ME59548
FL
2085D0003X
Diagnostic Neuroimaging (Radiology) Physician
ME59548
FL
2085N0700X
Neuroradiology Physician
ME59548
FL
2085R0202X
Diagnostic Radiology Physician
Primary
ME59548
FL
Other
Enumeration date
04/15/2008
Last updated
06/03/2008
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