1679535769 NPI number — OPEN MAGNETIC IMAGING INC

Table of content: DR. JONATHAN SETH WILENSKY MD (NPI 1871576470)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679535769 NPI number — OPEN MAGNETIC IMAGING INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OPEN MAGNETIC IMAGING INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1679535769
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/02/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2200 N COMMERCE PARKWAY
Provider Second Line Business Mailing Address:
STE 100
Provider Business Mailing Address City Name:
WESTON
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33326
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-888-6411
Provider Business Mailing Address Fax Number:
954-888-6414

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2200 N COMMERCE PARKWAY
Provider Second Line Business Practice Location Address:
STE 100
Provider Business Practice Location Address City Name:
WESTON
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33326
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-888-6411
Provider Business Practice Location Address Fax Number:
954-888-6414
Provider Enumeration Date:
04/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ACOSTA
Authorized Official First Name:
NELSON
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
954-888-6411

Provider Taxonomy Codes

  • Taxonomy code: 261QR0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: V2550 . This is a "BCBS-WB" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: V2553 . This is a "BCBS-J" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: V2421 . This is a "BCBS-PL" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: V2551 . This is a "BCBS-JAX" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: V2533 . This is a "BCBS-BB" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: V2539 . This is a "BCBS-CS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: V2470 . This is a "BCBS-W" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: V2540 . This is a "BCBS-PP" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: V2549 . This is a "BCBS-ML" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: V2555 . This is a "BCBS-CG" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: V2596 . This is a "BCBS-PB" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: V2534 . This is a "BCBS-K" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: V2691 . This is a "BCBS-OP" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 212732 . This is a "AMERIGROUP" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: V2552 . This is a "BCBS-AV" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: V2554 . This is a "BCBS-FTL" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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