Provider Demographics
NPI:1730375916
Name:BOCA RATON OPEN MRI,LLC
Entity type:Organization
Organization Name:BOCA RATON OPEN MRI,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:P
Authorized Official - Last Name:SOBIERALSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-226-0101
Mailing Address - Street 1:200 GLADES RD
Mailing Address - Street 2:SUITE #3
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-1420
Mailing Address - Country:US
Mailing Address - Phone:561-447-2131
Mailing Address - Fax:561-447-2119
Practice Address - Street 1:200 GLADES RD
Practice Address - Street 2:SUITE #3
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-1420
Practice Address - Country:US
Practice Address - Phone:561-447-2131
Practice Address - Fax:561-447-2119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-20
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC7130261QM1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)