Organization
FIRST COAST IMAGING LLC
Active
Other names
Jacksonville Upright MRI
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUAN C. LUIS-JORGE M.D. (MEDICAL DIRECTOR)
(904) 733-3700
Entity
Organization
Contact information
Practice address
4933 UNIVERSITY BLVD W, JACKSONVILLE, FL 32216-5935
(904) 733-7800
Mailing address
4933 UNIVERSITY BLVD W, JACKSONVILLE, FL 32216-5935
(904) 733-7800
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME0052228
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
303823
AVMED
FL
01
—
P00428579
RAILROAD MEDICARE
FL
01
—
V3100
BLUE SHIELD
FL
Enumeration date
06/24/2006
Last updated
03/11/2008
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