Provider Demographics
NPI:1760579411
Name:CENTRAL FLORIDA OPEN MRI INC
Entity Type:Organization
Organization Name:CENTRAL FLORIDA OPEN MRI INC
Other - Org Name:BEST OPEN MRI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FABIO
Authorized Official - Middle Name:
Authorized Official - Last Name:OLIVEROS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-385-2606
Mailing Address - Street 1:2821 US HWY 27 NORTH
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-1626
Mailing Address - Country:US
Mailing Address - Phone:863-402-0938
Mailing Address - Fax:863-402-0946
Practice Address - Street 1:2821 US HWY 27 NORTH
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-1626
Practice Address - Country:US
Practice Address - Phone:863-402-0938
Practice Address - Fax:863-402-0946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL258550200Medicaid
FLE1159Medicare PIN