Contract Details
Ancillary Care Services
Facility name
Simonmed Imaging Florida
Provider ID
P000005921
Tax ID
453727094
Effective Date
4/1/2012
Last Updated
9/30/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
92.00
Location Details
Address
9964 University Boulevard
Orlando, FL 32817
United States
County
Orange
Phone
4072612915 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address