JACKSONVILLE BEACHES MEDICAL IMAGING INC (NPI# 1548257041) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548257041 |
| Entity Type | Organization |
| Organization Name | JACKSONVILLE BEACHES MEDICAL IMAGING INC |
| Other Organization Name | JACKSONVILLE MEDICAL IMAGING |
| Practice Address |
2700 Riverside Ave Suite 1 Jacksonville FL 32205-8275 |
| Practice Telephone | 9043819994 |
| Practice Fax Number | 9043896866 |
| Mailing Telephone | 9043819994 |
| Mailing Fax Number | 9043896866 |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2012-10-02 |
| Authorized Official Name | MRS. CATHY BLAESE (CHIEF OPERATING OFFICER) |
| Authorized Official Telephone | 9042417772 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0200X |
Clinic/Center Specialization: Radiology |
HCCR1430 | FL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 1ST HEALTH PROVIDER # | 1840590 | 01 |
| FL | RR MEDICARE PROVIDER # | 470001666 | 01 |
| FL | BCBS FL PIN # | V2622 | 01 |
| FL | UNITED HEALTH CARE | 2000441 | 01 |
| FL | AETNA PROVIDER # | 7842141 | 01 |
| FL | 1ST HEALTH W/C # | 147878902 | 01 |
| Other Name | Type Code |
|---|---|
| JACKSONVILLE MEDICAL IMAGING | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568459055 | Jacksonville Beaches Medical Imaging Inc | Clinic/Center | 6138 Kennerly Rd, Suite 101, Jacksonville, FL 32216-4345 | 2005-09-30 |
| 1801883582 | Jacksonville Beaches Medical Imaging Inc | Clinic/Center | 3316 3rd St S, Suite 101, Jacksonville Beach, FL 32250-6073 | 2005-09-29 |
| Street Address |
2700 RIVERSIDE AVE SUITE 1 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32205-8275 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952706368 | Physicians Group Services Pa | Family Medicine | 2700 Riverside Ave, Suite 2, Jacksonville, FL 32205-8275 | 2014-10-28 |
| 1043524119 | Renee Gallo | Anesthesiology | 2700 Riverside Ave, Jacksonville, FL 32205-8275 | 2010-08-01 |
| 1508981689 | Jeffrey Howard Wachholz | Otolaryngology | 2700 Riverside Ave, Suite 7, Jacksonville, FL 32205-8275 | 2007-03-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003466830 | Brandon Neil Hillard | Registered Nurse | 1260 Mcduff Ave. South, Suite 4, Jacksonville, FL 32205 | 2019-09-13 |
| 1720436363 | Ericka Sampson | Massage Therapist | 6859 Lenox Ave., Suite 6, Jacksonville, FL 32205 | 2016-05-24 |
| 1578921631 | Northstar Counseling | Counselor | 1672 Pershing Rd, Jacksonville, FL 32205 | 2016-02-04 |
| 1649645144 | Magaly Perez-cruz | Speech-Language Pathologist | 4101-1 College Street, Jacksonville, FL 32205 | 2015-12-09 |
| 1639448723 | First Choice Adult Daycare and Home Health Ca | Specialist | 5336 Quan Drive, Jacksonville, FL 32205 | 2011-12-20 |
| 1437434222 | Christopher Styer | Pharmacist | 654 Casset Ave, Jacksonville, FL 32205 | 2011-10-12 |
| 1871827279 | April Marie Felton | Nurse Practitioner | 500 E. Adams Street, Bay Street Health Center, Jacksonville, FL 32205 | 2009-10-01 |
| 1922244821 | Danielle Marie Sergent | Physical Therapist | 5222 Lenox Ave., Jacksonville, FL 32205 | 2008-12-23 |
| 1427181775 | Lapp & Associates Behavioral Counselind Ctr | Counselor | 931 Cassat Avenue, Jacksonville, FL 32205 | 2007-03-14 |
| 1629143326 | Elias Moussa Sargi | Dentist | 2700 Riverside Avenue, Ste 10, Jacksonville, FL 32205 | 2006-11-21 |
| Find all providers in zip 32205 | ||||
| Taxonomy Code | 261QR0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487934311 | Gate Parkway Diagnostic Center Inc | Clinic/Center | 8075 Gate Pkwy W Ste 302, Jacksonville, FL 32216-3685 | 2011-08-23 |
| 1982875217 | Medical Diagnostic Center of Jacksonville | Clinic/Center | 3716 University Blvd S Ste 2, Jacksonville, FL 32216-4318 | 2008-03-14 |
| 1083802805 | San Jose Imaging Center LLC | Clinic/Center | 10696 Old Saint Augustine Rd, Jacksonville, FL 32257-1000 | 2007-10-05 |
| 1750405114 | Signet Diagnostic Imaging Services North Florida LLC | Clinic/Center | 4171 Roosevelt Blvd, Jacksonville, FL 32210-1837 | 2007-03-19 |
| 1225138787 | Radiology Health Imaging, LLC | Clinic/Center | 12404 Hatton Chase Lane West, Jacksonville, FL 32258 | 2006-09-25 |
| 1558375469 | Monument-9a Imaging & Diagnostic Center L L C | Clinic/Center | 1201 Monument Rd Ste 101, Jacksonville, FL 32225-6494 | 2006-07-28 |
| 1104849280 | The Medical Imaging Partnership Jax1 LLC | Clinic/Center | 7860 Gate Parkway, Suite 123, Jacksonville, FL 32256-7279 | 2006-07-26 |
| 1821050923 | Omi of Jacksonville Inc | Clinic/Center | 3716 University Blvd South, Jacksonville, FL 32216 | 2006-04-04 |
| 1538159819 | Allied Mobile Sono, Inc. | Clinic/Center | 3545 Saint Johns Bluff Rd S, Suite 1 # 274, Jacksonville, FL 32224-2682 | 2005-10-26 |
| 1568459055 | Jacksonville Beaches Medical Imaging Inc | Clinic/Center | 6138 Kennerly Rd, Suite 101, Jacksonville, FL 32216-4345 | 2005-09-30 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32205 |
Please comment or provide details below to improve the information on JACKSONVILLE BEACHES MEDICAL IMAGING INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.