San Jose Imaging Center LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

SAN JOSE IMAGING CENTER LLC

Doing business as

Innovative Imaging Jacksonville

Practice address

10696 Old Saint Augustine Rd
Jacksonville, FL 32257-1000

Phone

(904) 268-1080

Fax

(904) 268-3060

NPI assigned

Oct 5, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Paul Stanley

Title

Ceo

Phone

(813) 690-5720

Specialties & licenses 1

Addresses

Other names 1

• Innovative Imaging Jacksonville Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Aaron B. Montgomery, M.D.

  • Diagnostic Radiology Physician
  • Pensacola, FL
  • NPI 1144278169
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1191542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601856000000",
    "number": "1083802805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 270543",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336880543",
            "telephone_number": "850-478-1312",
            "fax_number": "850-474-9060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10696 OLD SAINT AUGUSTINE RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322571000",
            "telephone_number": "904-268-1080",
            "fax_number": "904-268-3060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN JOSE IMAGING CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-05",
        "last_updated": "2020-10-05",
        "certification_date": "2020-10-05",
        "status": "A",
        "authorized_official_last_name": "STANLEY",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "813-690-5720",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Innovative Imaging Jacksonville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• San Jose Chiropractic, LLC
• San Jose Clinic, P.a.
• San Jose Family Denistry
• San Jose Therapy Services LLC
• San Juan Dentistry PA
• San Juan Diagnostics LLC
• San Juan Retirement Home
• San Juan Retirement Home

• Radiology Clinic/Center in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Radiology Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.