Healthcare Provider Details

I. General information

NPI: 1437877313
Provider Name (Legal Business Name): CLR CONSULTING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2022
Last Update Date: 12/02/2022
Certification Date: 12/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7420 NW 5TH ST STE 107
PLANTATION FL
33317-1611
US

IV. Provider business mailing address

111 N PINE ISLAND RD STE 207
PLANTATION FL
33324-1836
US

V. Phone/Fax

Practice location:
  • Phone: 954-707-2559
  • Fax: 954-792-3342
Mailing address:
  • Phone: 954-707-2559
  • Fax: 954-792-3342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335V00000X
TaxonomyPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
License Number
License Number State

VIII. Authorized Official

Name: KENNETH B SANDLER
Title or Position: PD
Credential:
Phone: 954-707-2559