Contract Details
Ancillary Care Services
Facility name
Central Florida Open MRI
Provider ID
P000005289
NPI
1760579411
Tax ID
650828057
Effective Date
4/1/2012
Last Updated
10/2/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
2821 Highway 27 North
Sebring, FL 33870
United States
County
Highlands
Phone
8634020938 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address