Healthcare Provider Details

I. General information

NPI: 1881693828
Provider Name (Legal Business Name): BEACHES OPEN MRI OF TAMARAC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 05/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7186 N UNIVERSITY DR SUITE 1
TAMARAC FL
33321-2916
US

IV. Provider business mailing address

7186 N UNIVERSITY DR SUITE 1
TAMARAC FL
33321-2916
US

V. Phone/Fax

Practice location:
  • Phone: 954-722-4500
  • Fax: 954-722-4100
Mailing address:
  • Phone: 954-722-4500
  • Fax: 954-722-4100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number4080
License Number StateFL

VIII. Authorized Official

Name: DR. DAVID A CLAYMAN
Title or Position: MBR
Credential: M.D.
Phone: 954-722-4500