| Organization Name: | BEACHES OPEN MRI, LLC |
| NPI Number: | 1063564672 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARK S. FRISK (RADIOLOGIST) |
| Mailing Address: | 350 10th Ave S Jacksonville Beach |
| State: | FL US |
| Postal Code: | 322505136 |
| Phone Number: | 9042472220 |
| Fax Number: | 9042472296 |
| NPI Enumeration Date: | 01/17/2007 |
| NPI Last Update Date: | 01/24/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0200X |
| License Number: | 0700012919 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Radiology |
| Taxonomy Definition: | |