Provider Demographics
NPI:1437170644
Name:PROFESSIONAL IMAGING CONSULTANTS INC
Entity Type:Organization
Organization Name:PROFESSIONAL IMAGING CONSULTANTS INC
Other - Org Name:PROFESSIONAL IMAGING CONSULTANTS, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MEJIAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-493-3979
Mailing Address - Street 1:7780 LAKE UNDERHILL RD STE 109
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-8218
Mailing Address - Country:US
Mailing Address - Phone:407-493-3979
Mailing Address - Fax:407-678-9938
Practice Address - Street 1:7780 LAKE UNDERHILL RD STE 109
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-8218
Practice Address - Country:US
Practice Address - Phone:407-493-3979
Practice Address - Fax:407-678-9938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC61412085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE1521Medicare ID - Type Unspecified