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General NPI Number Information
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NPI Number | 1124010855
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Entity Type | Organization
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Legal Business Name | SOUTHEAST MEDICAL IMAGING SERVICES INC
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Dates
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Enumeration Date | 08/18/2005
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 4800 LINTON BLVD STE D503
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City | DELRAY BEACH
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State | FL
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Zip | 33445-6593
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Country | US
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Telephone | 561-865-3660
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Fax | 561-865-3661
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Provider Business Mailing Address
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Address Line | 4800 LINTON BLVD SUITE D-503
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City | DELRAY BEACH
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State | FL
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Zip | 33445-6584
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Country | US
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Telephone | 561-865-3660
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Fax | 561-865-3661
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ALEXIS F CRUZ
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Credential | RDMS
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Telephone | 561-865-3660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207UN0901X
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Taxonomy Name | Nuclear Cardiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 335V00000X
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Taxonomy Name | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
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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 | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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