National Provider Identifier Database

DAYTONA MRI LLC
Physiological Laboratory, (Independent Physiological Lab)

A laboratory that operates independently of a hospital and physician?s office to furnish physiological diagnostic services (e.g. EEG?s , EKG?s, scans, etc.). Facilities offering ONLY physiological services are not certified as independent laboratories. If an independent laboratory offers physiological services IN ADDITION to clinical laboratory services, they are surveyed only for compliance with the clinical laboratory regulations because there are no health and safety regulations for physiological services.


Contact Information

DAYTONA MRI LLC
125 MASON AVE
DAYTONA BEACH, FL32117-5017
Phone: 386-463-4444
Fax: 386-313-0304
Website:
Specialty Taxonomy Code
* Physiological Laboratory, (Independent Physiological Lab) 293D00000X
Magnetic Resonance Imaging Radiologic Technologist 2471M1202X
Radiography Radiologic Technologist 2471C3402X

* Indicates primary specialty

NPI Profile & details for DAYTONA MRI LLC

NPI Number 1316309800
Legal business name
LBN
DAYTONA MRI LLC
Authorized official JOHNATHAN WAGNER - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 03/23/2016
Last updated 05/31/2017 - About 9 years ago
Sole proprietor1 Not specified
Identifiers
  • FL Other: 1881628220 NPI TYPE 1

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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