Healthcare Provider Details

I. General information

NPI: 1699232223
Provider Name (Legal Business Name): INDEAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2019
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1192 BEMBRIDGE DR
ROCHESTER HILLS MI
48307-5715
US

IV. Provider business mailing address

1192 BEMBRIDGE DR
ROCHESTER HILLS MI
48307-5715
US

V. Phone/Fax

Practice location:
  • Phone: 248-690-6360
  • Fax:
Mailing address:
  • Phone: 248-690-6360
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335V00000X
TaxonomyPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
License Number
License Number State

VIII. Authorized Official

Name: ROMAN KOBITA
Title or Position: PRESIDENT
Credential:
Phone: 248-690-6360