Healthcare Provider Details

I. General information

NPI: 1306820295
Provider Name (Legal Business Name): NORTH BROWARD RADIOLOGISTS, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2005
Last Update Date: 09/24/2021
Certification Date: 09/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 S ANDREWS AVE
FORT LAUDERDALE FL
33316-2510
US

IV. Provider business mailing address

6330 N ANDREWS AVE STE 299
FORT LAUDERDALE FL
33309-2130
US

V. Phone/Fax

Practice location:
  • Phone: 954-355-5500
  • Fax:
Mailing address:
  • Phone: 954-839-8080
  • Fax: 954-839-8401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: RICHIE HEATH
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 407-310-7997