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General NPI Number Information
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NPI Number | 1114385754
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Entity Type | Organization
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Legal Business Name | R&A BLUE SONOWORLDS LLC
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Dates
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Enumeration Date | 02/09/2016
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Last Update Date | 02/09/2016
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Provider Practice Location Address
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Address Line | 425 SW 113TH WAY
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City | PEMBROKE PINES
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State | FL
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Zip | 33025-3446
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Country | US
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Telephone | 305-775-2306
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Fax |
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Provider Business Mailing Address
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Address Line | 425 SW 113TH WAY
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City | PEMBROKE PINES
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State | FL
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Zip | 33025-3446
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MISS ROSMERY MACHADO
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Credential | BHS, RDMS, RT(S)
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Telephone | 305-775-2306
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2471S1302X
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Taxonomy Name | Sonography Radiologic Technologist
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License Number |
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License Number State |
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