Provider Demographics
NPI:1760590913
Name:NORTH FLORIDA IMAGING CENTERS
Entity Type:Organization
Organization Name:NORTH FLORIDA IMAGING CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:J
Authorized Official - Last Name:ALEPA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:904-247-5551
Mailing Address - Street 1:2380 SOUTH THIRD STREET
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32250
Mailing Address - Country:US
Mailing Address - Phone:904-247-5551
Mailing Address - Fax:904-242-9748
Practice Address - Street 1:2380 SOUTH THIRD STREET
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32250
Practice Address - Country:US
Practice Address - Phone:904-247-5551
Practice Address - Fax:904-242-9748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-28
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC6257261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLV3033OtherBLUE SHIELD
FLV3033OtherBLUE SHIELD