Provider Demographics
NPI:1104373422
Name:PRECISION MRI CENTER
Entity Type:Organization
Organization Name:PRECISION MRI CENTER
Other - Org Name:PRECISION MRI CENTER LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:JESUS
Authorized Official - Last Name:RIOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-682-9116
Mailing Address - Street 1:3500 HOLLYWOOD BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-6809
Mailing Address - Country:US
Mailing Address - Phone:954-266-4210
Mailing Address - Fax:954-289-5948
Practice Address - Street 1:3500 HOLLYWOOD BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021
Practice Address - Country:US
Practice Address - Phone:954-266-4210
Practice Address - Fax:954-289-5948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-02
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)