Basic Information
| Provider Information | |||||||||
| NPI: | 1437499217 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | A1 X-RAY SERVICES, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2 N TAMIAMI TRL | ||||||||
| Address2: | SUITE 210 | ||||||||
| City: | SARASOTA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 342365574 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9419253490 | ||||||||
| FaxNumber: | 9419254914 | ||||||||
| Practice Location | |||||||||
| Address1: | 2 N TAMIAMI TRL | ||||||||
| Address2: | SUITE 210 | ||||||||
| City: | SARASOTA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 342365574 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9419253490 | ||||||||
| FaxNumber: | 9419254914 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/15/2013 | ||||||||
| LastUpdateDate: | 02/15/2013 | ||||||||
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| AuthorizedOfficialLastName: | RADAKOVIC | ||||||||
| AuthorizedOfficialFirstName: | MARILYN | ||||||||
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| AuthorizedOfficialTitleorPosition: | COO | ||||||||
| AuthorizedOfficialTelephone: | 9419253490 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | A1 IMAGING CENTERS, LLC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR0208X | Y | Ambulatory Health Care Facilities | Clinic/Center | Radiology, Mobile |
No ID Information.