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DAYTONA MRI LLC NPI 1316309800


NPI Information

NPI: 1316309800
Provider Name: DAYTONA MRI LLC
Classification: Physiological Laboratory - 293D00000X
Entity Type: Organization
Address:
125 MASON AVE
DAYTONA BEACH, FL
ZIP 32117
Phone: (386) 463-4444
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DAYTONA MRI LLC is a physiological laboratory in Daytona Beach, FL. The provider is a laboratory that operates independently of a hospital and physician's office to furnish physiological diagnostic services (e.g. EEG's , EKG's, scans, etc.). Facilities offering ONLY physiological services are not certified as independent laboratories. If an independent laboratory offers physiological services IN ADDITION to clinical laboratory services, they are surveyed only for compliance with the clinical laboratory regulations because there are no health and safety regulations for physiological services. DAYTONA MRI LLC NPI is 1316309800. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

125 MASON AVE
DAYTONA BEACH, FL
ZIP 32117-017
Phone: (386) 463-4444
Fax: (386) 313-0304

The provider's authorized official is Johnathan Livingston Wagner .
The authorized official title is Owner and has the following contact phone number (386) 463-4444.

The enumeration date for this NPI number is 3/23/2016 and was last updated on 5/31/2017.


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
12471C3402XRadiologic TechnologistRadiographyNo
22471M1202XRadiologic TechnologistMagnetic Resonance ImagingNo
3293D00000XPhysiological LaboratoryYes

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
11881628220OTHERFLORIDANPI TYPE 1

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: 5/5/2024

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