Healthcare Provider Details

I. General information

NPI: 1265703037
Provider Name (Legal Business Name): HENDLEY DIAGNOSTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2012
Last Update Date: 01/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

426 9TH AVE
VERO BEACH FL
32962-1542
US

IV. Provider business mailing address

426 9TH AVE
VERO BEACH FL
32962-1542
US

V. Phone/Fax

Practice location:
  • Phone: 772-569-7861
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2471S1302X
TaxonomySonography Radiologic Technologist
License Number
License Number State

VIII. Authorized Official

Name: MAURICE HENDLEY
Title or Position: CARDIOVASCULAR TECHNOLOGIST
Credential: RCS
Phone: 772-569-7861