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General NPI Number Information
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NPI Number | 1396590386
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Entity Type | Organization
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Legal Business Name | DIAGNOSTIC CENTERS OF AMERICA LLP
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Dates
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Enumeration Date | 04/22/2024
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Last Update Date | 04/22/2024
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Provider Practice Location Address
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Address Line | 1434 COMMODORE WAY
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City | HOLLYWOOD
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State | FL
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Zip | 33019-5061
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Country | US
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Telephone | 956-369-0733
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Fax |
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Provider Business Mailing Address
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Address Line | 5775 WAYZATA BLVD STE 400
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City | ST LOUIS PARK
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State | MN
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Zip | 55416-1271
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Country | US
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Telephone | 952-738-4418
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Fax |
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Authorized Official
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Title or Position | SPECIAL ASSISTANT SECRETARY
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Name | SUSAN C HOLMAN
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Credential |
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Telephone | 952-513-6831
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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