Provider Demographics
NPI:1861744823
Name:DIAGNOSTIC MEDICAL IMAGING OF HOLLYWOOD LLC
Entity type:Organization
Organization Name:DIAGNOSTIC MEDICAL IMAGING OF HOLLYWOOD LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:ISSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-980-0398
Mailing Address - Street 1:6517 TAFT STREET
Mailing Address - Street 2:SUITE 103
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024
Mailing Address - Country:US
Mailing Address - Phone:954-780-5566
Mailing Address - Fax:954-780-5567
Practice Address - Street 1:6517 TAFT STREET
Practice Address - Street 2:SUITE 103
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024
Practice Address - Country:US
Practice Address - Phone:954-780-5566
Practice Address - Fax:954-780-5567
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RMI DIAGNOSTIC, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-10-15
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology