Healthcare Provider Details

I. General information

NPI: 1477971539
Provider Name (Legal Business Name): DIAGNOSTIC CENTER OF PALM BEACH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2014
Last Update Date: 04/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2640 FOREST HILL BLVD
WEST PALM BEACH FL
33406-5931
US

IV. Provider business mailing address

2640 FOREST HILL BLVD
WEST PALM BEACH FL
33406-5931
US

V. Phone/Fax

Practice location:
  • Phone: 561-281-8480
  • Fax: 561-429-2181
Mailing address:
  • Phone: 561-281-8480
  • Fax: 561-429-2181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MAIKEL RODRIGUEZ
Title or Position: OWNER
Credential:
Phone: 561-281-8480