| Organization Name: | BEAUFORT OPEN MRI, LLC |
| NPI Number: | 1053375642 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PAUL MAZZEO (NEUROLOGIST) |
| Mailing Address: | 1319 Ladys Island Dr Port Royal |
| State: | SC US |
| Postal Code: | 299351153 |
| Phone Number: | 8435246736 |
| Fax Number: | 8435241386 |
| NPI Enumeration Date: | 04/12/2006 |
| NPI Last Update Date: | 02/06/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM1200X |
| License Number: | 14702 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Magnetic Resonance Imaging (MRI) |
| Taxonomy Definition: | |