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General NPI Number Information
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NPI Number | 1508513441
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Entity Type | Organization
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Legal Business Name | DIVERSITY MRI OF FLORIDA INC
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Dates
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Enumeration Date | 03/09/2022
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Last Update Date | 03/09/2022
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Provider Practice Location Address
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Address Line | 801 S UNIVERSITY DR STE K103A
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City | PLANTATION
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State | FL
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Zip | 33324-3367
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Country | US
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Telephone | 954-905-7217
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Fax | 954-905-7218
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Provider Business Mailing Address
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Address Line | 760 PONCE DE LEON BLVD
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City | CORAL GABLES
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State | FL
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Zip | 33134-2075
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Country | US
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Telephone | 954-905-7217
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Fax | 954-905-7218
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSHUA RUSKIN
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Credential |
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Telephone | 954-905-7217
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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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