Organization
DRS. MCCLOW, CLARK & BERK PA
Active
Other names
MCB Radiology
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ARIO REZAEI MD (PRESIDENT)
(904) 388-6949
Entity
Organization
Contact information
Practice address
1 SHIRCLIFF WAY, JACKSONVILLE, FL 32204-4748
(904) 308-7300
Mailing address
PO BOX 161180, ALTAMONTE SPRINGS, FL 32716-1180
(904) 388-6949
(904) 388-1841
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00308
BC BS OF FLORIDA
FL
05
—
051598100
—
FL
05
—
051598104
—
FL
05
—
051598105
—
FL
05
—
051598106
—
FL
05
—
051598107
—
FL
05
—
051598108
—
FL
05
—
300037068A
—
GA
01
—
CF1461
RR MEDICARE
FL
Enumeration date
05/04/2006
Last updated
08/15/2023
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