Contract Details
Ancillary Care Services
Facility name
Mid Florida Imaging
Provider ID
P000005499
NPI
1861598310
Tax ID
593572096
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
6342 West Colonial Drive Suite C
Orlando, FL 32818
United States
County
Orange
Phone
4075230411 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address