Provider Demographics
NPI:1467336263
Name:MRI AND 3D DIAGNOSTIC CENTER LLC
Entity type:Organization
Organization Name:MRI AND 3D DIAGNOSTIC CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:STACY
Authorized Official - Middle Name:A
Authorized Official - Last Name:MASTROSIMONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-392-3341
Mailing Address - Street 1:7158 W COLONIAL DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32818-6751
Mailing Address - Country:US
Mailing Address - Phone:407-601-3604
Mailing Address - Fax:407-412-5115
Practice Address - Street 1:7158 W COLONIAL DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32818-6751
Practice Address - Country:US
Practice Address - Phone:407-601-3604
Practice Address - Fax:407-412-5115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)