Healthcare Provider Details

I. General information

NPI: 1528988896
Provider Name (Legal Business Name): LIFESPAN BREAST AND IMAGING CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 15TH ST
WEST PALM BEACH FL
33401-2734
US

IV. Provider business mailing address

321 15TH ST
WEST PALM BEACH FL
33401-2734
US

V. Phone/Fax

Practice location:
  • Phone: 561-407-0212
  • Fax: 561-448-4887
Mailing address:
  • Phone: 561-407-0212
  • Fax: 561-448-4887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2471M2300X
TaxonomyMammography Radiologic Technologist
License Number
License Number State

VIII. Authorized Official

Name: DR. ORNA HADAR
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 561-407-0212