Provider Demographics
NPI:1114920279
Name:UNIVERSITY MRI RADIOLOGY ASSOCIATES, PL
Entity Type:Organization
Organization Name:UNIVERSITY MRI RADIOLOGY ASSOCIATES, PL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FRED
Authorized Official - Middle Name:
Authorized Official - Last Name:STEINBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-362-9191
Mailing Address - Street 1:3848 NW 8TH AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-6437
Mailing Address - Country:US
Mailing Address - Phone:561-362-9191
Mailing Address - Fax:561-394-5674
Practice Address - Street 1:3848 NW 8TH AVE
Practice Address - Street 2:STE 200
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-6437
Practice Address - Country:US
Practice Address - Phone:561-362-9191
Practice Address - Fax:561-394-5674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-23
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK5727Medicare ID - Type Unspecified