Organization
PROFESSIONAL DIAGNOSTIC READING MRI INC.
Active
Other names
Advanced MRI Diagnostics
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE VIVAS (CFO)
(904) 399-2500
Entity
Organization
Contact information
Practice address
3728 PHILLIPS HWY, STE34, JACKSONVILLE, FL 32207-9300
(904) 399-2500
(904) 399-2495
Mailing address
3728 PHILLIPS HWY, STE34, JACKSONVILLE, FL 32207-9300
(904) 399-2500
(904) 399-2495
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
1000032322
FL
261QR0200X
Radiology Clinic/Center
1000032322
FL
Other
Enumeration date
07/14/2011
Last updated
02/27/2013
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