Healthcare Provider Details

I. General information

NPI: 1982934188
Provider Name (Legal Business Name): NATIONAL MEDICAL IMAGING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2010
Last Update Date: 01/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2620 NW 15TH CT
POMPANO BEACH FL
33069-1525
US

IV. Provider business mailing address

2620 NW 15TH CT
POMPANO BEACH FL
33069-1525
US

V. Phone/Fax

Practice location:
  • Phone: 954-353-5651
  • Fax:
Mailing address:
  • Phone: 954-353-5651
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335V00000X
TaxonomyPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. ANWAR MITHAVAYANI
Title or Position: DIRECTOR
Credential:
Phone: 954-353-5651