OrganizationSummerlin Imaging Center Llc(Jacksonville Diagnostic Imaging)RadiologyAllopathic & Osteopathic PhysiciansPractice Address3550 University Blvd S Ste 102, Jacksonville, FL 32216-4227(561) 331-0808PECOS EnrollmentBased on the most recent information from CMS, provider Summerlin Imaging Center Llc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1316596471Provider TypeOrganizationFull NameSummerlin Imaging Center LlcOther NameJacksonville Diagnostic ImagingSubpartNoEnumeration Date9/10/2019Last Updated3/27/2020Contact InformationPractice LocationPractice Address3550 University Blvd S Ste 102, Jacksonville, FL 32216-4227Phone(561) 331-0808FaxUnlisted FaxMailing LocationMailing Address6415 Lake Worth Rd Ste 102, Greenacres, FL 33463-3009Phone(561) 331-0808Fax(561) 237-6034Authorized OfficialNamePeters, Bradford G (Financial Officer)Phone(561) 331-0808Provider TaxonomiesCodeDescriptionLicenseCode2085R0202XPrimaryDescriptionRadiologyAllopathic & Osteopathic PhysiciansLicenseUnlisted Issuer