OrganizationMedical Diagnostic Center Of Jacksonville(<Unavail>)RadiologyAllopathic & Osteopathic PhysiciansPractice Address3550 University Blvd S, Ste 102, Jacksonville, FL 32216-4246(904) 731-7296PECOS EnrollmentBased on the most recent information from CMS, provider Medical Diagnostic Center Of Jacksonville 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 11:34 AM.Profile DetailsProvider ID1356331326Provider TypeOrganizationFull NameMedical Diagnostic Center Of JacksonvilleOther Name<Unavail>SubpartNoEnumeration Date10/21/2005Last Updated8/22/2020Contact InformationPractice LocationPractice Address3550 University Blvd S, Ste 102, Jacksonville, FL 32216-4246Phone(904) 731-7296Fax(904) 636-9875Mailing LocationMailing Address3550 University Blvd S, Ste 102, Jacksonville, FL 32216-4246Phone(904) 731-7296Fax(904) 636-9875Authorized OfficialNameSacaquini, Nicolau (Business Director)Phone(904) 731-1556Provider TaxonomiesCodeDescriptionLicenseCode2085R0202XPrimaryDescriptionRadiologyAllopathic & Osteopathic PhysiciansLicenseUnlisted Issuer