| NPI | 1780249094 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA KASSA Authorized Official 904-610-4653 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology |
| Additional Taxonomies | 261QR0200X Clinic/Center Radiology |
| 261QM1200X Clinic/Center Magnetic Resonance Imaging (MRI) | |
| Enumeration Date | 2019-05-02 |
| Last Update Date | 2025-06-13 |