Organization
FOUNTAIN IMAGING OF PLANTATION
Active
Other names
FOUNTAIN IMAGING
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTI LYNN HEBERT (ADMINISTRATOR)
(954) 888-1816
Entity
Organization
Contact information
Practice address
301 NW 84TH AVE, SUITE #100, PLANTATION, FL 33324-1807
(954) 888-1816
(954) 476-5238
Mailing address
301 NW 84TH AVE, SUITE #100, PLANTATION, FL 33324-1807
(954) 888-1816
(954) 476-5238
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
HCC4211
FL
Other
Enumeration date
12/28/2006
Last updated
08/22/2020
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