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General NPI Number Information
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NPI Number | 1376906537
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Entity Type | Organization
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Legal Business Name | RADIOLOGY IMAGING FACILITIES,LLC
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Dates
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Enumeration Date | 04/04/2016
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Last Update Date | 04/04/2016
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Provider Practice Location Address
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Address Line | 3800 JOHNSON ST STE C
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City | HOLLYWOOD
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State | FL
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Zip | 33021-6030
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Country | US
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Telephone | 954-494-3032
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Fax |
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Provider Business Mailing Address
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Address Line | 4251 MANGRUM CT
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City | HOLLYWOOD
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State | FL
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Zip | 33021-2419
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Country | US
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Telephone | 954-494-3032
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. HERBERT L SHICK
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Credential | MD
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Telephone | 954-494-3032
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | L13000099384
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License Number State | FL
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