Organization
BOCA RATON OPEN IMAGING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAVELLE HARDIN (CREDENTIALING COORDINATOR)
(615) 344-8203
Entity
Organization
Contact information
Practice address
1601 CLINT MOORE ROAD, SUITE 140, BOCA RATON, FL 33487
(561) 939-0850
(561) 939-0899
Mailing address
1601 CLINT MOORE ROAD, SUITE 140, BOCA RATON, FL 33487
(561) 939-0850
(561) 939-0899
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
—
—
261QR0200X
Radiology Clinic/Center
Primary
—
—
261QR0206X
Mammography Clinic/Center
—
—
Other
Enumeration date
10/03/2007
Last updated
10/03/2007
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