Provider Demographics
NPI:1467818021
Name:GLOBAL DIAGNOSTIC IMAGING CENTERS, INC
Entity Type:Organization
Organization Name:GLOBAL DIAGNOSTIC IMAGING CENTERS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-493-6741
Mailing Address - Street 1:6349 BEACH BLVD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-2707
Mailing Address - Country:US
Mailing Address - Phone:904-493-6741
Mailing Address - Fax:
Practice Address - Street 1:6349 BEACH BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-2707
Practice Address - Country:US
Practice Address - Phone:904-493-6741
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-12
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME61126261QM1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)