Healthcare Provider Details

I. General information

NPI: 1205258480
Provider Name (Legal Business Name): A&J DIAGNOSTIC CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2014
Last Update Date: 02/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 E LINTON BLVD STE 134A
DELRAY BEACH FL
33483-3345
US

IV. Provider business mailing address

100 E LINTON BLVD STE 134A
DELRAY BEACH FL
33483-3345
US

V. Phone/Fax

Practice location:
  • Phone: 561-876-4399
  • Fax:
Mailing address:
  • Phone: 561-876-4399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246XS1301X
TaxonomySonography Specialist/Technologist Cardiovascular
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State

VIII. Authorized Official

Name: AGNIESZKA MCKEN
Title or Position: PRESIDENT
Credential:
Phone: 561-876-4399