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General NPI Number Information
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NPI Number | 1235925595
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Entity Type | Organization
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Legal Business Name | 3D IMAGING OF BROWARD LLC
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Dates
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Enumeration Date | 04/15/2025
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 7200 W COMMERCIAL BLVD STE 209
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City | LAUDERHILL
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State | FL
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Zip | 33319-2148
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Country | US
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Telephone | 954-368-8108
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 616756
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City | ORLANDO
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State | FL
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Zip | 32861-6756
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Country | US
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Telephone | 352-250-1679
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. SANFORD MARK
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Credential | DC
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Telephone | 352-250-1679
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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