WEST BOYNTON BEACH OPEN IMAGING CENTER LLC NPI 1477721405

NPI Information

NPI: 1477721405
Provider Name: WEST BOYNTON BEACH OPEN IMAGING CENTER LLC
Classification: Clinic/Center - 261QR0200X
Entity Type: Organization

Specialization: Radiology

CLIA Number: 10D2170033

Address:
10151 ENTERPRISE CENTER BLVD
SUITE 109
BOYNTON BEACH, FL
ZIP 33437
Phone: (561) 752-5050
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WEST BOYNTON BEACH OPEN IMAGING CENTER LLC is a radiology clinic center in Boynton Beach, FL. WEST BOYNTON BEACH OPEN IMAGING CENTER LLC NPI is 1477721405. The provider is registered as an organization entity type.

The provider's business location address is:

10151 ENTERPRISE CENTER BLVD
SUITE 109
BOYNTON BEACH, FL
ZIP 33437-759
Phone: (561) 752-5050
Fax: (561) 364-5606

The provider's authorized official is Lavelle R Hardin .
The authorized official title is Coordinator and has the following contact phone number (615) 344-8203.

The CLIA number assigned to this NPI record is 10D2170033 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/12/2008 and was last updated on 2/20/2010.

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	Primary
1	261QM1200X	Clinic/Center	Magnetic Resonance Imaging (MRI)	No
2	261QR0206X	Clinic/Center	Radiology, Mammography	No
3	261QR0200X	Clinic/Center	Radiology	Yes

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
1	000260600	MEDICAID	FLORIDA
2	V3267	OTHER	FLORIDA	BCBS

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: 11/14/2023

NPI Synchronization or Removal

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