Provider Demographics
NPI:1124287990
Name:A1 IMAGING OF JACKSONVILLE LLC
Entity type:Organization
Organization Name:A1 IMAGING OF JACKSONVILLE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SENIOR VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BABITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-336-4336
Mailing Address - Street 1:100 BAYVIEW CIR
Mailing Address - Street 2:SUITE 250
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2983
Mailing Address - Country:US
Mailing Address - Phone:949-336-4336
Mailing Address - Fax:949-336-4346
Practice Address - Street 1:6349 BEACH BLVD
Practice Address - Street 2:SUITE 1A
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-2707
Practice Address - Country:US
Practice Address - Phone:904-722-3939
Practice Address - Fax:904-722-3922
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:A1 IMAGING CENTERS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-05
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)