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General NPI Number Information
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NPI Number | 1154306140
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Entity Type | Organization
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Legal Business Name | SOUTH FLORIDA DIAGNOSTICS INC
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Dates
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Enumeration Date | 12/13/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1380 NW 65TH AVE
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City | PLANTATION
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State | FL
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Zip | 33313-4555
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Country | US
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Telephone | 954-792-6038
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Fax | 954-792-6233
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Provider Business Mailing Address
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Address Line | 1380 NW 65TH AVE
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City | PLANTATION
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State | FL
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Zip | 33313-4555
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Country | US
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Telephone | 954-792-6038
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Fax | 954-792-6233
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Authorized Official
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Title or Position | PRESIDENT OWNER
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Name | MISS SALLIE BROWN
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Credential | RCP
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Telephone | 954-792-6038
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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