Provider Demographics
NPI:1558493742
Name:X-CEL MOBILE MEDICAL IMAGING INC
Entity Type:Organization
Organization Name:X-CEL MOBILE MEDICAL IMAGING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:TERESA
Authorized Official - Last Name:MACNICOL
Authorized Official - Suffix:
Authorized Official - Credentials:ARRT
Authorized Official - Phone:239-352-9225
Mailing Address - Street 1:180 12TH ST SE
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34117-3667
Mailing Address - Country:US
Mailing Address - Phone:239-352-9225
Mailing Address - Fax:888-400-8530
Practice Address - Street 1:4707 ENTERPRISE AVE
Practice Address - Street 2:UNIT 7
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34104-7064
Practice Address - Country:US
Practice Address - Phone:239-352-9225
Practice Address - Fax:239-434-5465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC5809335V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA630000893OtherRAIL ROAD MEDICARE
FL030526000Medicaid
FLW9883Medicare ID - Type UnspecifiedPROVIDER NUMBER