Provider Demographics
NPI:1912139510
Name:WEST PALM BEACH MRI, LLC
Entity Type:Organization
Organization Name:WEST PALM BEACH MRI, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF BUSINESS DEVELOPMENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:MAIMONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-541-5401
Mailing Address - Street 1:5601 CORPORATE WAY
Mailing Address - Street 2:BUILDING 3
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-2025
Mailing Address - Country:US
Mailing Address - Phone:561-686-0506
Mailing Address - Fax:561-687-5601
Practice Address - Street 1:5601 CORPORATE WAY
Practice Address - Street 2:BUILDING 3
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2025
Practice Address - Country:US
Practice Address - Phone:561-686-0506
Practice Address - Fax:561-687-5601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-14
Last Update Date:2010-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC3694261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology