Provider Demographics
NPI:1538911037
Name:DIAGNOSTIC IMAGING OF SOUTH FLORIDA LLC
Entity type:Organization
Organization Name:DIAGNOSTIC IMAGING OF SOUTH FLORIDA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:SHANIKIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-904-1150
Mailing Address - Street 1:PO BOX 222651
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33422-2651
Mailing Address - Country:US
Mailing Address - Phone:561-904-1150
Mailing Address - Fax:561-584-5088
Practice Address - Street 1:11476 OKEECHOBEE BLVD
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-8715
Practice Address - Country:US
Practice Address - Phone:561-904-1150
Practice Address - Fax:561-584-5088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-05
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology