SOUTHERN OPEN MRI INC NPI 1194795658

NPI Information

  • NPI: 1194795658
  • Provider Name: SOUTHERN OPEN MRI INC
  • Classification: Radiologic Technologist - 2471M1202X
  • Specialization: Magnetic Resonance Imaging
  • Entity Type: Organization
  • Doing Business As: SOUTHERN OPEN IMAGING CENTER
  • Address: 289 SW STONEGATE TER
    SUITE 102
    LAKE CITY, FL
    ZIP 32024
  • Phone: (386) 755-4788

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NPI Details

SOUTHERN OPEN MRI INC is a magnetic resonance imaging radiologic technologist in Lake City, FL. The provider is a radiologic technologist who specializes in magnetic resonance imaging (MRI) and is appropriately educated and trained, consistent with nationally recognized standards, state statute, and facility policy in performance of MRIs, exam techniques, equipment protocols, radiation safety, and patient care. SOUTHERN OPEN MRI INC NPI is 1194795658. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Southern Open Imaging Center.

The provider's business location address is:

289 SW STONEGATE TER
SUITE 102
LAKE CITY, FL
ZIP 32024-456
Phone: (386) 755-4788
Fax: (386) 755-9980

The provider's authorized official is Lucia M Delauz-sami .
The authorized official title is Vp/ceo/manager and has the following contact phone number (386) 755-4788.

The enumeration date for this NPI number is 1/25/2006 and was last updated on 2/19/2008.

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
12471C3401XRadiologic TechnologistComputed TomographyNo
22471S1302XRadiologic TechnologistSonographyNo
32471M1202XRadiologic TechnologistMagnetic Resonance ImagingYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1271288OTHERFLORIDAAVMED PROVIDER NUMBER
21736853OTHERFLORIDAFIRST HEALTH PROVIDER NUM
3V2546OTHERFLORIDABLUE CROSS BLUE SHIELD
45259706OTHERFLORIDAAETNA PROVIDER NUMBER
5B796OTHERFLORIDAVISTA HEALTH PLAN
6E2274MEDICARE PINFLORIDA

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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