Healthcare Provider Details

I. General information

NPI: 1013908912
Provider Name (Legal Business Name): INDEPENDENT IMAGING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2005
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2425 E COMMERCIAL BLVD STE 101
FORT LAUDERDALE FL
33308-4003
US

IV. Provider business mailing address

2425 E COMMERCIAL BLVD STE 101
FORT LAUDERDALE FL
33308-4003
US

V. Phone/Fax

Practice location:
  • Phone: 954-909-0270
  • Fax: 844-889-8133
Mailing address:
  • Phone: 954-909-0270
  • Fax: 844-889-8133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License NumberHCC8429
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code261QR0206X
TaxonomyMammography Clinic/Center
License NumberHCC1449
License Number StateFL

VIII. Authorized Official

Name: ALEX LUNDY
Title or Position: MANAGER
Credential:
Phone: 954-909-0270