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General NPI Number Information
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NPI Number | 1174588743
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Entity Type | Organization
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Legal Business Name | HORIZON MOBILE DIAGNOSTIC INC
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Dates
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Enumeration Date | 04/18/2006
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Last Update Date | 06/20/2013
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Provider Practice Location Address
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Address Line | 201 NW 70TH AVE SUITE D-1
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City | PLANTATION
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State | FL
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Zip | 33317-2369
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Country | US
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Telephone | 954-641-1501
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Fax | 954-641-1506
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Provider Business Mailing Address
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Address Line | 201 NW 70TH AVE SUITE D-1
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City | PLANTATION
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State | FL
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Zip | 33317-2369
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Country | US
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Telephone | 954-641-1501
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Fax | 954-641-1506
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | MRS. ARELIS HERRERA
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Credential |
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Telephone | 954-641-1501
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number | HCC4464
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License Number State | FL
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