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General NPI Number Information
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NPI Number | 1184657900
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Entity Type | Organization
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Legal Business Name | SOUTHERN IMAGING ASSOCIATES, INC.
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 6736 N UNIVERSITY DR
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City | TAMARAC
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State | FL
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Zip | 33321-4013
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Country | US
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Telephone | 954-724-5791
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Fax | 954-724-5141
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Provider Business Mailing Address
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Address Line | 6736 N UNIVERSITY DR
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City | TAMARAC
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State | FL
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Zip | 33321-4013
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Country | US
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Telephone | 954-724-5791
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Fax | 954-724-5141
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. IVAN HYPPOLITE
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Credential |
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Telephone | 954-724-5191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
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License Number | HCC6452
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | HCC6452
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License Number State | FL
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