1679535769 NPI number — OPEN MAGNETIC IMAGING INC

Table of content: (NPI 1679535769)

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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