Organization
IMAGINE MEDICAL INTERNATIONAL LLC
Active
Other names
Imagine Medical International
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AVANIKA KHANNA GROVER DDS (CHIEF CLINICAL OFFICER)
(469) 323-9093
Entity
Organization
Contact information
Practice address
10151 DEERWOOD PARK BLVD STE 200-250, JACKSONVILLE, FL 32256-0589
(904) 486-0746
Mailing address
10151 DEERWOOD PARK BLVD STE 200-250, JACKSONVILLE, FL 32256-0589
(904) 486-0746
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
05/20/2021
Last updated
05/20/2021
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