Provider Demographics
NPI:1811145162
Name:A1 IMAGING CENTERS LLC
Entity type:Organization
Organization Name:A1 IMAGING CENTERS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:
Authorized Official - Last Name:RADAKOVIC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-285-6661
Mailing Address - Street 1:1800 2ND ST
Mailing Address - Street 2:SUITE 915
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34236-5946
Mailing Address - Country:US
Mailing Address - Phone:941-315-9876
Mailing Address - Fax:
Practice Address - Street 1:20880 W DIXIE HWY
Practice Address - Street 2:SUITE 111/106
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33180-1151
Practice Address - Country:US
Practice Address - Phone:941-925-3490
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:A1 IMAGING CENTERS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-08-28
Last Update Date:2015-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLBI822Medicare PIN