South Florida Mobile Open MRI, LLC

Primary specialty

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

License

CRT54864 Issued in FL

Legal business name

SOUTH FLORIDA MOBILE OPEN MRI, LLC

Practice address

4348 Forest Hill Blvd
West Palm Beach, FL 33406-5718

Phone

(561) 641-6093

Fax

(561) 641-6094

NPI assigned

Sep 6, 2008

Organization subpart

No

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

Authorized official

Name

Forrest Allen Wright, RT (R) (MR)

Title

Owner/President

Phone

(305) 360-3220

Specialties & licenses 1

Addresses

Other names 1

• Premier Diagnostic Imaging Doing business as

Locations

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

{
    "created_epoch": "1220659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477612800000",
    "number": "1285882910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4348 FOREST HILL BLVD",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334065718",
            "telephone_number": "561-641-6093",
            "fax_number": "561-641-6094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4348 FOREST HILL BLVD",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334065718",
            "telephone_number": "561-641-6093",
            "fax_number": "561-641-6094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH FLORIDA MOBILE OPEN MRI, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-06",
        "last_updated": "2016-10-28",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "FORREST",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "305-360-3220",
        "authorized_official_credential": "RT (R) (MR)"
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": "FL",
            "license": "CRT54864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Diagnostic Imaging",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Magnetic Resonance Imaging (MRI) Clinic/Center in West Palm Beach, FL
• Providers in West Palm Beach, 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 Oct 28, 2016; 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.