Provider Demographics
NPI:1750070660
Name:MILLENNIUM MRI INC
Entity type:Organization
Organization Name:MILLENNIUM MRI INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MIROSLAV
Authorized Official - Middle Name:
Authorized Official - Last Name:JAKSIC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-623-3211
Mailing Address - Street 1:2900 E BAY DR
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33771-2637
Mailing Address - Country:US
Mailing Address - Phone:810-623-3211
Mailing Address - Fax:
Practice Address - Street 1:2019 E SILVER SPRINGS BLVD STE 301
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34470-8224
Practice Address - Country:US
Practice Address - Phone:352-900-5501
Practice Address - Fax:352-900-5502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-05
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)