Organization
JUPITER EFL IMAGING CENTER LLC
Active
Other names
Jupiter Open Imaging Center
Organization subpart
No
Provider details
NPI number
Authorized official
WANDA FOGARTY (VP IMAGING SERVICES)
(561) 838-3630
Entity
Organization
Contact information
Practice address
875 MILITARY TRL, SUITE 101, JUPITER, FL 33458-5700
(561) 748-9828
(561) 748-2490
Mailing address
875 MILITARY TRL, SUITE 101, JUPITER, FL 33458-5700
(561) 748-9828
(561) 748-2490
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
272378600
—
FL
Enumeration date
04/06/2006
Last updated
05/18/2010
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