Medical Diagnostic Center of Jacksonville

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

MEDICAL DIAGNOSTIC CENTER OF JACKSONVILLE

Doing business as

Southbank Imaging Services

Practice address

3550 University Blvd S
Ste 102
Jacksonville, FL 32216-4246

Phone

(904) 731-7296

Fax

(904) 636-9875

NPI assigned

Oct 21, 2005

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Nicolau Sacaquini

Title

Business Director

Phone

(904) 731-1556

Specialties & licenses 1

Addresses

Other names 1

• SOUTHBANK IMAGING SERVICES Doing business as

Locations

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

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356331326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3550 UNIVERSITY BLVD S",
            "address_2": "STE 102",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164246",
            "telephone_number": "904-731-7296",
            "fax_number": "904-636-9875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 UNIVERSITY BLVD S",
            "address_2": "STE 102",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164246",
            "telephone_number": "904-731-7296",
            "fax_number": "904-636-9875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL DIAGNOSTIC CENTER OF JACKSONVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SACAQUINI",
        "authorized_official_first_name": "NICOLAU",
        "authorized_official_title_or_position": "BUSINESS DIRECTOR",
        "authorized_official_telephone_number": "904-731-1556",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTHBANK IMAGING SERVICES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Medex Clinic, LLC (Medex Clinic)
• Medfund LLC (Horizon Jacksonville North LLC)
• Medfund LLC (Horizon Mandarin LLC)
• Medical Care Products Inc
• Medical Diagnostic Center of Jacksonville
• Medical Diagnostic Center of Jacksonville (Southbank Imaging Service)
• Medical Diagnostic Center of Jacksonville
• Medical Diagnostic Center of Jacksonville
• Medical Diagnostic Professional Management (Logic Diagnostics of Jacksonville)
• Medical Examiner's Office

• Diagnostic Radiology Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Diagnostic Radiology Physician 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.