Southern Open MRI Inc

Primary specialty

Magnetic Resonance Imaging Radiologic TechnologistTaxonomy code 2471M1202X

Legal business name

SOUTHERN OPEN MRI INC

Practice address

289 SW Stonegate Ter
Suite 102
Lake City, FL 32024-3456

Phone

(386) 755-4788

Fax

(386) 755-9980

NPI assigned

Jan 25, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Lucia M Delauz-Sami, RT(R)

Title

VP/Ceo/Manager

Phone

(386) 755-4788

Specialties & licenses 3

Addresses

Other identifiers 5

Other names 1

• Southern Open Imaging Center Doing business as

Locations

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203379200000",
    "number": "1194795658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "289 SW STONEGATE TER",
            "address_2": "SUITE 102",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320243456",
            "telephone_number": "386-755-4788",
            "fax_number": "386-755-9980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "289 SW STONEGATE TER",
            "address_2": "SUITE 102",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320243456",
            "telephone_number": "386-755-4788",
            "fax_number": "386-755-9980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN OPEN MRI INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-25",
        "last_updated": "2008-02-19",
        "status": "A",
        "authorized_official_last_name": "DELAUZ-SAMI",
        "authorized_official_first_name": "LUCIA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "VP/CEO/MANAGER",
        "authorized_official_telephone_number": "386-755-4788",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RT(R)"
    },
    "taxonomies": [
        {
            "code": "2471C3401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiologic Technologist, Computed Tomography",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2471M1202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiologic Technologist, Magnetic Resonance Imaging",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2471S1302X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiologic Technologist, Sonography",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER NUMBER",
            "identifier": "5259706",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VISTA HEALTH PLAN",
            "identifier": "B796",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "V2546",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH PROVIDER NUM",
            "identifier": "1736853",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED PROVIDER NUMBER",
            "identifier": "271288",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Open Imaging Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tonna Jeanette Sotolongo, A.R.N.P
• South Florida Surgical Specialists, LLC
• Southeast Radiology Associates PL
• Southern Internal Medicine PLLC
• Southern Interventional Pain Center LLC
• Elizabeth Diane Sparkman
• Speech and Reading Center, LLC
• Patricia Spencer
• Leslee Stafford
• Meko Stafford

• Magnetic Resonance Imaging Radiologic Technologist in Lake City, FL
• Providers in Lake City, FL by specialty
• Magnetic Resonance Imaging Radiologic Technologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; 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.