Healthcare Provider Details
I. General information
NPI: 1275094203
Provider Name (Legal Business Name): WOMEN'S IMAGING INSTITUTE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/31/2019
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8397 W OAKLAND PARK BLVD
SUNRISE FL
33351-7307
US
IV. Provider business mailing address
8397 W OAKLAND PARK BLVD
SUNRISE FL
33351-7307
US
V. Phone/Fax
- Phone: 954-998-1887
- Fax: 954-440-0902
- Phone: 954-998-1887
- Fax: 954-440-0902
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0204X |
| Taxonomy | Vascular & Interventional Radiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PRIYANKA
GROVER
Title or Position: MEDICAL DOCTOR/MANAGER
Credential: M.D.
Phone: 954-998-1887