Organization
MEDICAL DIAGNOSTIC PROFESSIONAL MANAGEMENT
Active
Other names
LOGIC DIAGNOSTICS OF JACKSONVILLE
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE MOTHERSIL (MANAGEMENT)
(904) 440-0998
Entity
Organization
Contact information
Practice address
8380 BAYMEADOWS RD STE 17, JACKSONVILLE, FL 32256-7435
(904) 440-0998
Mailing address
8380 BAYMEADOWS RD STE 17, JACKSONVILLE, FL 32256-7435
(904) 440-0998
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
—
—
261QR0208X
Mobile Radiology Clinic/Center
—
—
Other
Enumeration date
05/01/2017
Last updated
10/26/2017
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