Organization
CONCEPT EFL IMAGING CENTER LLC
Active
Other names
Concept 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
2290 10TH AVE N, SUITE 101, LAKE WORTH, FL 33461-6607
(561) 540-8100
(561) 493-2261
Mailing address
2290 10TH AVE N, SUITE 101, LAKE WORTH, FL 33461-6607
(561) 540-8100
(561) 493-2261
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
272322100
—
FL
Enumeration date
04/06/2006
Last updated
05/18/2010
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