Provider Demographics
NPI:1679535769
Name:OPEN MAGNETIC IMAGING INC
Entity Type:Organization
Organization Name:OPEN MAGNETIC IMAGING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NELSON
Authorized Official - Middle Name:
Authorized Official - Last Name:ACOSTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-888-6411
Mailing Address - Street 1:2200 N COMMERCE PARKWAY
Mailing Address - Street 2:STE 100
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326
Mailing Address - Country:US
Mailing Address - Phone:954-888-6411
Mailing Address - Fax:954-888-6414
Practice Address - Street 1:2200 N COMMERCE PARKWAY
Practice Address - Street 2:STE 100
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326
Practice Address - Country:US
Practice Address - Phone:954-888-6411
Practice Address - Fax:954-888-6414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-04
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLV2550OtherBCBS-WB
FLV2553OtherBCBS-J
FLV2421OtherBCBS-PL
FLV2551OtherBCBS-JAX
FLV2533OtherBCBS-BB
FLV2539OtherBCBS-CS
FLV2470OtherBCBS-W
FLV2540OtherBCBS-PP
FLV2549OtherBCBS-ML
FLV2555OtherBCBS-CG
FLV2596OtherBCBS-PB
FLV2534OtherBCBS-K
FLV2691OtherBCBS-OP
FL212732OtherAMERIGROUP
FLV2552OtherBCBS-AV
FLV2554OtherBCBS-FTL
FLV2691OtherBCBS-OP
FLV2549OtherBCBS-ML
FLV2552OtherBCBS-AV
FLV2553OtherBCBS-J