Contract Details
Ancillary Care Services
Facility name
Boca Raton Imaging Center
Provider ID
P000005863
Tax ID
223826279
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
1590 Northwest 10th Avenue Suite 202
Boca Raton, FL 33486
United States
County
Palm Beach
Phone
5613687956 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address