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General NPI Number Information
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NPI Number | 1134882673
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Entity Type | Organization
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Legal Business Name | NORTH BROWARD RADIOLOGISTS, P.A.
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Dates
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Enumeration Date | 10/21/2021
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Last Update Date | 10/21/2021
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Provider Practice Location Address
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Address Line | 1601 S ANDREWS AVE FL 23
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City | FT LAUDERDALE
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State | FL
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Zip | 33316-2509
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Country | US
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Telephone | 954-355-5500
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Fax |
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Provider Business Mailing Address
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Address Line | 6330 N ANDREWS AVE STE 299
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City | FT LAUDERDALE
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State | FL
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Zip | 33309-2130
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Country | US
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Telephone | 954-839-8080
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | RICHIE HEATH
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Credential |
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Telephone | 407-310-7997
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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