Provider Demographics
NPI:1053643833
Name:ACK-TEN GROUP LLC
Entity Type:Organization
Organization Name:ACK-TEN GROUP LLC
Other - Org Name:SEACREST MRI OF BOYNTON BEACH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ALEXANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABELOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-739-9674
Mailing Address - Street 1:2404 S SEACREST BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-6704
Mailing Address - Country:US
Mailing Address - Phone:561-739-9674
Mailing Address - Fax:561-739-9674
Practice Address - Street 1:2828 S SEACREST BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-7944
Practice Address - Country:US
Practice Address - Phone:561-739-9674
Practice Address - Fax:561-739-9688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-04
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC8658261Q00000X, 261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center