Organization
MEDICAL DIAGNOSTIC PROFESSIONAL MANAGEMENT
Active
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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