Provider Demographics
NPI:1689650210
Name:AMERICAN HEALTH IMAGING OF FLORIDA LLC
Entity Type:Organization
Organization Name:AMERICAN HEALTH IMAGING OF FLORIDA LLC
Other - Org Name:PREMIER ADVANCED IMAGING OF LAKE MARY LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:WARREN
Authorized Official - Last Name:ARANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-296-5887
Mailing Address - Street 1:1800 CENTURY BLVD NE
Mailing Address - Street 2:SUITE 1400
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30345-3202
Mailing Address - Country:US
Mailing Address - Phone:404-296-5887
Mailing Address - Fax:
Practice Address - Street 1:610 CRESCENT EXECUTIVE CT
Practice Address - Street 2:SUITE 100
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-2110
Practice Address - Country:US
Practice Address - Phone:407-804-1500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-15
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE9137Medicare PIN