Healthcare Provider Details

I. General information

NPI: 1326251760
Provider Name (Legal Business Name): SOUND EXPANSION ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 06/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17610 WOODVIEW TER
BOCA RATON FL
33487-2228
US

IV. Provider business mailing address

17610 WOODVIEW TER
BOCA RATON FL
33487-2228
US

V. Phone/Fax

Practice location:
  • Phone: 561-998-5579
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2471S1302X
TaxonomySonography Radiologic Technologist
License Number3047
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2471V0105X
TaxonomyVascular Sonography Radiologic Technologist
License Number3047
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code246XS1301X
TaxonomySonography Specialist/Technologist Cardiovascular
License Number3047
License Number StateFL

VIII. Authorized Official

Name: PETER VINING
Title or Position: PRESIDENT
Credential: RDMS, RCDS, RVT
Phone: 561-998-5579