Healthcare Provider Details

I. General information

NPI: 1831509983
Provider Name (Legal Business Name): HOLY CROSS OUTPATIENT SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2014
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1799 S. FEDERAL HIGHWAY
BOCA RATON FL
33432
US

IV. Provider business mailing address

4725 NORTH FEDERAL HIGHWAY
FORT LAUDERDALE FL
33308
US

V. Phone/Fax

Practice location:
  • Phone: 561-347-7933
  • Fax: 561-347-7923
Mailing address:
  • Phone: 954-771-8000
  • Fax: 954-482-5741

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT CASALOU
Title or Position: PRESIDENT & CEO
Credential:
Phone: 734-712-3792