Basic Information
| Provider Information | |||||||||
| NPI: | 1164409413 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | STONEHILL INVESTMENT PARTNERSHIP, INC. | ||||||||
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| OtherOrganizationName: | OPEN MRI OF SANFORD | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 501 S. LINCOLN AVE. | ||||||||
| Address2: | #15 | ||||||||
| City: | CLEARWATER | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337565945 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7274466760 | ||||||||
| FaxNumber: | 7274412465 | ||||||||
| Practice Location | |||||||||
| Address1: | 303 W. FIRST ST. | ||||||||
| Address2: | |||||||||
| City: | SANFORD | ||||||||
| State: | FL | ||||||||
| PostalCode: | 32771 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4073307333 | ||||||||
| FaxNumber: | 4073307928 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/28/2005 | ||||||||
| LastUpdateDate: | 09/24/2010 | ||||||||
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| AuthorizedOfficialLastName: | ABOUD | ||||||||
| AuthorizedOfficialFirstName: | ANTHONY | ||||||||
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| AuthorizedOfficialTitleorPosition: | C.E.O. | ||||||||
| AuthorizedOfficialTelephone: | 7274466760 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | D.O. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM1200X | HCC4828 | FL | Y | Ambulatory Health Care Facilities | Clinic/Center | Magnetic Resonance Imaging (MRI) |
ID Information
| ID | Type | State | Issuer | Description | 470001429 | 01 | FL | RAILROAD MEDICARE | OTHER | 059921200 | 05 | FL | MEDICAID |