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General NPI Number Information
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NPI Number | 1003182056
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Entity Type | Organization
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Legal Business Name | NATIONAL IMAGING AND URGENT CARE, INC.
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Dates
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Enumeration Date | 03/23/2012
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Last Update Date | 04/21/2015
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Provider Practice Location Address
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Address Line | 3601 W COMMERCIAL BLVD SUITE 20
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City | FORT LAUDERDALE
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State | FL
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Zip | 33309-3300
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Country | US
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Telephone | 954-915-3028
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Fax | 954-714-6078
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Provider Business Mailing Address
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Address Line | 3601 W COMMERCIAL BLVD SUITE 20
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City | FORT LAUDERDALE
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State | FL
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Zip | 33309-3300
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Country | US
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Telephone | 954-915-3028
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Fax | 954-714-6078
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Authorized Official
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Title or Position | PRESIDENT
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Name | PETE TYNDALE
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Credential |
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Telephone | 954-915-3028
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME84420
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | PT27280
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 261QM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | ARNP2810312
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | ME84420
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License Number State | FL
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