Provider Demographics
NPI:1497046353
Name:IMAGING CENTER OF WEST PALM BEACH LLC
Entity type:Organization
Organization Name:IMAGING CENTER OF WEST PALM BEACH LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SARNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-766-1301
Mailing Address - Street 1:2450 METROCENTRE BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-3105
Mailing Address - Country:US
Mailing Address - Phone:561-684-9020
Mailing Address - Fax:561-684-9060
Practice Address - Street 1:3440 HOLLYWOOD BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021
Practice Address - Country:US
Practice Address - Phone:561-684-9020
Practice Address - Fax:561-684-9060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-27
Last Update Date:2018-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261QM1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)