Contract Details
Ancillary Care Services
Facility name
A1 Imaging of Ocoee
Provider ID
P000004593
NPI
1457511511
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
9450 West Colonial Drive Suite 12
Ocoee, FL 34761
United States
County
Orange
Phone
4078220999 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address