Fountain Imaging of Pembroke Pines,LLC

Primary specialty

Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X

License

HCC7166 Issued in FL

Legal business name

FOUNTAIN IMAGING OF PEMBROKE PINES,LLC

Doing business as

FOUNTAIN IMAGING

Practice address

2221 N University Dr
Suite a
Pembroke Pines, FL 33024-3603

Phone

(954) 983-4266

Fax

(954) 983-4233

NPI assigned

Dec 28, 2006

Organization subpart

No

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

Authorized official

Name

Kristi Lynn Hebert

Title

Administrator

Phone

(954) 983-4266

Specialties & licenses 1

Addresses

Other names 1

• FOUNTAIN IMAGING Doing business as

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114083847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2221 N UNIVERSITY DR",
            "address_2": "SUITE A",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330243603",
            "telephone_number": "954-983-4266",
            "fax_number": "954-983-4233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2221 N UNIVERSITY DR",
            "address_2": "SUITE A",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330243603",
            "telephone_number": "954-983-4266",
            "fax_number": "954-983-4233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNTAIN IMAGING OF PEMBROKE PINES,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HEBERT",
        "authorized_official_first_name": "KRISTI",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "954-983-4266"
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": "FL",
            "license": "HCC7166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FOUNTAIN IMAGING",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Magnetic Resonance Imaging (MRI) Clinic/Center in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Magnetic Resonance Imaging (MRI) Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.