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NPI Code Detail

MEDICARE: SOUTH FLORIDA MEDICAL IMAGING, PA

MEDICARE: SOUTH FLORIDA MEDICAL IMAGING, PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085B0100XBody Imaging Physician
22085D0003XDiagnostic Neuroimaging (Radiology) Physician
32085N0700XNeuroradiology Physician
42085N0904XNuclear Radiology Physician
52085P0229XPediatric Radiology Physician
62085R0204XVascular & Interventional Radiology Physician
72085U0001XDiagnostic Ultrasound Physician
82085R0202XDiagnostic Radiology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1518945575
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTH FLORIDA MEDICAL IMAGING, PA
Provider Business Mailing Address
First Line : PO BOX 11398
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33339-1398
Country : US
Telephone Number : 844-215-3267
Fax Number : 772-621-3180
Provider Business Practice Location Address
First Line : 4725 N FEDERAL HWY
Second Line :
City : FT LAUDERDALE
State : FL
Zip : 33308-4603
Country : US
Telephone Number : 954-202-0277
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. MICHAEL RUSH
Credential : MD
Telephone Number : 954-636-2290
Provider Enumeration Date : 01/09/2006
Last Update Date : 08/03/2021

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