Provider Demographics
NPI:1235269671
Name:HEALTH IMAGING NETWORK LLC
Entity Type:Organization
Organization Name:HEALTH IMAGING NETWORK LLC
Other - Org Name:OPEN MRI OF WESTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:V. PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANAYS
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLAZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-217-7674
Mailing Address - Street 1:2625 EXECUTIVE PARK DR
Mailing Address - Street 2:SUITE ONE
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33331-3634
Mailing Address - Country:US
Mailing Address - Phone:954-217-7674
Mailing Address - Fax:954-217-7675
Practice Address - Street 1:2625 EXECUTIVE PARK DR
Practice Address - Street 2:SUITE ONE
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33331-3634
Practice Address - Country:US
Practice Address - Phone:954-217-7674
Practice Address - Fax:954-217-7675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC70552085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE4600Medicare ID - Type Unspecified