OrganizationBoutique Breast Imaging, LlcRadiologyAllopathic & Osteopathic PhysiciansPractice Address6871 Belfort Oaks Pl, Jacksonville, FL 32216-6242(904) 553-8806PECOS EnrollmentBased on the most recent information from CMS, provider Boutique Breast Imaging, 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 yesterday at 11:51 AM.Profile DetailsProvider ID1952180887Provider TypeOrganizationFull NameBoutique Breast Imaging, LlcSubpartNoEnumeration Date9/28/2023Last Updated10/2/2023Contact InformationPractice LocationPractice Address6871 Belfort Oaks Pl, Jacksonville, FL 32216-6242Phone(904) 553-8806FaxUnlisted FaxMailing LocationMailing Address823 Waterman Rd N, Jacksonville, FL 32207-5240Phone(904) 553-8806FaxUnlisted FaxAuthorized OfficialNamePeyton, Kathryn Pearson (Manager)Phone(904) 553-8806Provider TaxonomiesCodeDescriptionLicenseCode2085R0202XPrimaryDescriptionRadiologyAllopathic & Osteopathic PhysiciansLicenseUnlisted IssuerCode261QR0206XDescriptionClinic/CenterAmbulatory Health Care FacilitiesLicenseUnlisted Issuer