Healthcare Provider Details

I. General information

NPI: 1942727516
Provider Name (Legal Business Name): INSPIRED INTERVENTIONAL RADIOLOGY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2017
Last Update Date: 06/27/2024
Certification Date: 06/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11011 SHERIDAN ST STE 102
HOLLYWOOD FL
33026-1501
US

IV. Provider business mailing address

11011 SHERIDAN ST STE 102
HOLLYWOOD FL
33026-1501
US

V. Phone/Fax

Practice location:
  • Phone: 754-208-3310
  • Fax: 954-200-8725
Mailing address:
  • Phone: 754-208-3310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0206X
TaxonomyMammography Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberME97951
License Number StateFL

VIII. Authorized Official

Name: DR. HILARIO MARTINEZ
Title or Position: MEMBER
Credential: MD
Phone: 845-705-8983