Provider Demographics
NPI:1184676645
Name:A1 OPEN MRI, INC.
Entity Type:Organization
Organization Name:A1 OPEN MRI, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RITA
Authorized Official - Middle Name:
Authorized Official - Last Name:HEARST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-596-5222
Mailing Address - Street 1:2825 N UNIVERSITY DR
Mailing Address - Street 2:SUITE # 100
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-1440
Mailing Address - Country:US
Mailing Address - Phone:954-596-5222
Mailing Address - Fax:954-596-5020
Practice Address - Street 1:2825 N UNIVERSITY DR
Practice Address - Street 2:SUITE 100
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-1440
Practice Address - Country:US
Practice Address - Phone:954-596-5222
Practice Address - Fax:954-596-5020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC6741174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU2368Medicare ID - Type UnspecifiedRADIOLOGY