Contract Details
Ancillary Care Services
Facility name
Open MRI of Boca
Provider ID
P000005790
NPI
1992793798
Tax ID
542113525
Effective Date
4/1/2012
Last Updated
10/1/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
880 Northwest 13th Street Suite 101
Boca Raton, FL 33486
United States
County
Palm Beach
Phone
5613684486 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address