Healthcare Provider Details

I. General information

NPI: 1952781775
Provider Name (Legal Business Name): NEXUS DIAGNOSTIC SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2015
Last Update Date: 06/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1451 W CYPRESS CREEK RD SUITE 300
FT LAUDERDALE FL
33309-1961
US

IV. Provider business mailing address

1451 W CYPRESS CREEK RD SUITE 300
FT LAUDERDALE FL
33309-1961
US

V. Phone/Fax

Practice location:
  • Phone: 800-223-2278
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME 34003
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MRS. SIMONE SACKS
Title or Position: DIRECTOR
Credential:
Phone: 855-223-2378