Provider Demographics
NPI:1326893595
Name:OHRI, LLC
Entity Type:Organization
Organization Name:OHRI, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR. DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:YESENIA
Authorized Official - Middle Name:GOMEZ
Authorized Official - Last Name:MOSHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-842-3777
Mailing Address - Street 1:1414 KUHL AVE # MP212
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-2008
Mailing Address - Country:US
Mailing Address - Phone:407-331-9355
Mailing Address - Fax:407-331-9481
Practice Address - Street 1:5565 N WICKHAM RD
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-7304
Practice Address - Country:US
Practice Address - Phone:407-331-9355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OHRI, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology