Provider Demographics
NPI:1437433935
Name:PROFESSIONAL DIAGNOSTIC READING MRI INC
Entity type:Organization
Organization Name:PROFESSIONAL DIAGNOSTIC READING MRI INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:TUREK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:900-400-5752
Mailing Address - Street 1:2800 N MILITARY TRL
Mailing Address - Street 2:STE 108
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-2951
Mailing Address - Country:US
Mailing Address - Phone:561-616-9095
Mailing Address - Fax:561-616-9094
Practice Address - Street 1:2800 N MILITARY TRL
Practice Address - Street 2:STE 108
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-2951
Practice Address - Country:US
Practice Address - Phone:561-616-9095
Practice Address - Fax:561-616-9094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-03
Last Update Date:2013-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME91047261QM1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHCC 9391OtherAHCA