A1 Imaging of St Augustine LLC

Primary specialty

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

License

HCC7757 Issued in FL

Legal business name

A1 IMAGING OF ST AUGUSTINE LLC

Doing business as

A1 Imaging of St Augustine

Practice address

200 Southpark Blvd
Ste 210
St Augustine, FL 32086-3101

Phone

(904) 819-0920

Fax

(904) 819-0299

NPI assigned

Jan 30, 2009

Last updated

Dec 4, 2014By the provider in NPPES

Organization subpart

Yes

Parent organization

A1 IMAGING CENTERS LLCAs reported in NPPES

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

Authorized official

Name

Marilyn Radakovic

Title

Coo

Phone

(951) 285-6661

Specialties & licenses 1

Addresses

Other names 1

• A1 IMAGING OF ST AUGUSTINE Doing business as

Part of

A1 Imaging Centers LLC

Locations

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

{
    "created_epoch": "1233273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417651200000",
    "number": "1124266010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 2ND ST",
            "address_2": "SUITE 915",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342365946",
            "telephone_number": "941-315-9876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SOUTHPARK BLVD",
            "address_2": "STE 210",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320863101",
            "telephone_number": "904-819-0920",
            "fax_number": "904-819-0299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A1 IMAGING OF ST AUGUSTINE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "A1 IMAGING CENTERS LLC",
        "enumeration_date": "2009-01-30",
        "last_updated": "2014-12-04",
        "status": "A",
        "authorized_official_last_name": "RADAKOVIC",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "951-285-6661"
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": "FL",
            "license": "HCC7757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "A1 IMAGING OF ST AUGUSTINE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Magnetic Resonance Imaging (MRI) Clinic/Center in St Augustine, FL
• Providers in St Augustine, 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 Dec 4, 2014; 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.