Provider Demographics
NPI:1902272065
Name:THE OPEN MRI GUY'S OF PALM BEACH
Entity Type:Organization
Organization Name:THE OPEN MRI GUY'S OF PALM BEACH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:RT(R)MR
Authorized Official - Phone:954-797-6744
Mailing Address - Street 1:1441 FOREST HILL BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-6095
Mailing Address - Country:US
Mailing Address - Phone:954-797-6744
Mailing Address - Fax:954-316-6946
Practice Address - Street 1:1441 FOREST HILL BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-6095
Practice Address - Country:US
Practice Address - Phone:954-797-6744
Practice Address - Fax:954-316-6946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-12
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center