Provider Demographics
NPI:1679305197
Name:PALM BEACH IMAGING GROUP LLC
Entity type:Organization
Organization Name:PALM BEACH IMAGING GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PD
Authorized Official - Prefix:
Authorized Official - First Name:GIOVANNI
Authorized Official - Middle Name:R
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-800-4788
Mailing Address - Street 1:5917 S CONGRESS AVE
Mailing Address - Street 2:
Mailing Address - City:ATLANTIS
Mailing Address - State:FL
Mailing Address - Zip Code:33462-1303
Mailing Address - Country:US
Mailing Address - Phone:561-800-4788
Mailing Address - Fax:561-209-0561
Practice Address - Street 1:5917 S CONGRESS AVE
Practice Address - Street 2:
Practice Address - City:ATLANTIS
Practice Address - State:FL
Practice Address - Zip Code:33462-1303
Practice Address - Country:US
Practice Address - Phone:561-800-4788
Practice Address - Fax:561-209-0561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)