SUNCOAST OPEN MRI LLC (NPI# 1134188824) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134188824 |
| Entity Type | Organization |
| Organization Name | SUNCOAST OPEN MRI LLC |
| Other Organization Name | SUNCOAST DIAGNOSTIC IMAGING |
| Practice Address |
511 E 23rd St Panama City FL 32405-5307 |
| Mailing Address |
Po Box 4003 Macon GA 31208 |
| Practice Telephone | 8507478822 |
| Mailing Telephone | 4787559966 |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2007-11-28 |
| Authorized Official Name | PETER O HOLLIDAY III (DIRECTOR) |
| Authorized Official Telephone | 4784742360 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QR0200X |
Clinic/Center Specialization: Radiology |
Ambulatory Health Care Facilities | ||
| Y | 261QM1200X |
Clinic/Center Specialization: Magnetic Resonance Imaging (MRI) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BCBS | V2722 | 01 |
| Other Name | Type Code |
|---|---|
| Suncoast Diagnostic Imaging | Doing Business As Name - Organization |
| Street Address |
511 E 23RD ST |
| City | PANAMA CITY |
| State | FL |
| Zip Code | 32405-5307 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770905457 | Jennifer Valle | Radiologic Technologist | 511 E 23rd St, Panama City, FL 32405-5307 | 2014-01-14 |
| 1912329699 | Summer Sheppard | Radiologic Technologist | 511 E 23rd St, Panama City, FL 32405-5307 | 2014-01-14 |
| 1902146525 | Tiffany N West | Radiologic Technologist | 511 E 23rd St, Panama City, FL 32405-5307 | 2013-02-19 |
| 1134417595 | Cecil Jay Lynn | Spec/Tech, Cardiovascular | 511 E 23rd St, Panama City, FL 32405-5307 | 2011-07-19 |
| 1558659912 | Mary M Jones | Spec/Tech, Cardiovascular | 511 E 23rd St, Panama City, FL 32405-5307 | 2011-07-19 |
| 1861729253 | Nikitta Ashley Bobzien | Radiologic Technologist | 511 E 23rd St, Panama City, FL 32405-5307 | 2009-11-06 |
| 1457586869 | Denice L Spencer | Radiologic Technologist | 511 E 23rd St, Panama City, FL 32405-5307 | 2009-05-29 |
| 1417125576 | Natalie D Badger | Radiologic Technologist | 511 E 23rd St, Panama City, FL 32405-5307 | 2008-02-12 |
| 1598873663 | Tracy Lynee Vanderschaaf | Radiologic Technologist | 511 E 23rd St, Panama City, FL 32405-5307 | 2006-08-28 |
| 1568480580 | Jennifer Jone Johns | Radiologic Technologist | 511 E 23rd St, Panama City, FL 32405-5307 | 2006-07-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457962136 | Kimberlea Fox | Behavioral Analyst | 4750 Collegiate Drive, Technology Building 157, Panama City, FL 32405 | 2020-08-14 |
| 1598325714 | Covenant Home Health Care, LLC | Home Health | 107 W. 19th Street, Panama City, FL 32405 | 2019-06-19 |
| 1467921403 | Amy Hancock | Counselor | 1212 W. 19th St., Panama City, FL 32405 | 2018-11-20 |
| 1063991917 | Patricia Kagendo Mutunga | Day Training, Developmentally Disabled Services | 2813 Fairmont Dr, Panama City, FL 32405 | 2018-08-11 |
| 1871087882 | Southeastern Dermatology Group Pa | Pharmacy | 2505 Harrison Ave Ste A, Panama City, FL 32405 | 2018-06-22 |
| 1346733615 | Jessica Nicole Graham | Nurse Practitioner | 2507 Harrison Ave Unit 101, Panama City, FL 32405 | 2018-06-12 |
| 1437658424 | Coastal Mobility Transportation, LLC | Non-emergency Medical Transport (VAN) | 203 Forest Park Circle, Panama City, FL 32405 | 2018-02-06 |
| 1003314915 | The Anti-aging Clinic of Northwest Florida | Obstetrics & Gynecology | 3019 Osprey Cir, Panama City, FL 32405 | 2018-01-25 |
| 1255848487 | Sarah Theriot | Social Worker | 700 W 23rd St Bldg H, Panama City, FL 32405 | 2018-01-09 |
| 1336686054 | Angela Leake | Registered Nurse | 449 W 23 St, Panama City, FL 32405 | 2017-01-20 |
| Find all providers in zip 32405 | ||||
| Taxonomy Code | 261QM1200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Magnetic Resonance Imaging (MRI) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932700176 | Mri Associates of Crystal River | Clinic/Center | 6136 W Gulf To Lake Hwy, Crystal River, FL 34429-7558 | 2020-11-04 |
| 1477168714 | Indago Imaging | Clinic/Center | 3716 W 12th Ave, Hialeah, FL 33012-4126 | 2020-09-14 |
| 1417577669 | Ahc Diagnostic and Imaging Services | Clinic/Center | 8000 Sw 67th Avenue, Miami, FL 33143 | 2020-04-17 |
| 1548880784 | Lee County Mri Inc | Clinic/Center | 2215 Winkler Ave Ste G, Fort Myers, FL 33901-9150 | 2020-04-17 |
| 1053942383 | Musculoskeletal Institute Chartered | Clinic/Center | 2044 Trinity Oaks Blvd Ste 110, Trinity, FL 34655-4405 | 2020-01-27 |
| 1407497647 | Proscan Imaging Naples LLC | Clinic/Center | 8340 Sierra Meadows Blvd Ste 103, Naples, FL 34113-7328 | 2019-09-30 |
| 1851940100 | Express Medical Imaging, LLC | Clinic/Center | 6300 Saint Johns Ave, Palatka, FL 32177-3884 | 2019-09-10 |
| 1104478601 | Flagler Mri Diagnostic Inc | Clinic/Center | 8000 W Flagler St Ste 102, Miami, FL 33144-2157 | 2019-07-15 |
| 1205497260 | South Miami Open Mri LLC | Clinic/Center | 6161 Sunset Dr Ste A, South Miami, FL 33143-5045 | 2019-06-21 |
| 1215592829 | Advance Scans & Imaging Center Inc. | Clinic/Center | 2453 N State Road 7, Lauderdale Lakes, FL 33313-3723 | 2019-05-08 |
| Find all providers with the same taxonomy | ||||
| City | PANAMA CITY |
| Zip Code | 32405 |
Please comment or provide details below to improve the information on SUNCOAST OPEN MRI LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.