FIRST COAST IMAGING LLC NPI 1053523670

NPI Information

  • NPI: 1053523670
  • Provider Name: FIRST COAST IMAGING, LLC
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • Doing Business As: SELECT DIAGNOSTICS
  • CLIA Number: 10D1075935
  • Address: 159 N 3RD ST
    MACCLENNY, FL
    ZIP 32063
  • Phone: (904) 733-7800

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NPI Details

FIRST COAST IMAGING, LLC is a specialist in Macclenny, FL. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. FIRST COAST IMAGING, LLC NPI is 1053523670. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Select Diagnostics.

The provider's business location address is:

159 N 3RD ST
MACCLENNY, FL
ZIP 32063-103
Phone: (904) 733-7800
Fax: (904) 419-4888

The provider's authorized official is Juan C. Luis-jorge .
The authorized official title is Medical Director and has the following contact phone number (904) 733-7800.

The CLIA number assigned to this NPI record is 10D1075935 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/4/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialistME0052228FLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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