Contract Details
Ancillary Care Services
Facility name
A1 Imaging of Orlando
Provider ID
P000005247
NPI
1740449784
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
500 North Semoran Boulevard Suite 103
Orlando, FL 32807
United States
County
Orange
Phone
4072756072 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address