Healthcare Provider Details
I. General information
NPI: 1124111414
Provider Name (Legal Business Name): QMG LLC DBA INSITE RADIOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/02/2006
Last Update Date: 08/19/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9050 PINES BLVD STE 160
PEMBROKE PINES FL
33024-6400
US
IV. Provider business mailing address
210 S FEDERAL HWY STE 403
HOLLYWOOD FL
33020-6811
US
V. Phone/Fax
- Phone: 954-431-7627
- Fax: 954-431-7733
- Phone: 954-929-3400
- Fax: 954-929-2001
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM1200X |
| Taxonomy | Magnetic Resonance Imaging (MRI) Clinic/Center |
| License Number | ME20137 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QR0206X |
| Taxonomy | Mammography Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR0200X |
| Taxonomy | Radiology Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARK
GRNJA
Title or Position: PRESIDENT
Credential:
Phone: 954-929-3400