Contract Details
Ancillary Care Services
Facility name
A1 Imaging of Kissimmee
Provider ID
P000004592
NPI
1457511503
Tax ID
262562595
Effective Date
4/1/2012
Last Updated
9/30/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
84.00
Location Details
Address
810 North John Young Parkway
Kissimmee, FL 34741
United States
County
Osceola
Phone
3526227459 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address