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General NPI Number Information
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NPI Number | 1508859695
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Entity Type | Organization
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Legal Business Name | WEST PALM BEACH RESOURCES, INC
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Dates
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Enumeration Date | 08/24/2005
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Last Update Date | 11/28/2025
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Provider Practice Location Address
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Address Line | 7520 SW 57TH AVE STE A
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-5330
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Country | US
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Telephone | 833-674-3668
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Fax |
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Provider Business Mailing Address
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Address Line | 10320 GUATEMALA ST
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City | HOLLYWOOD
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State | FL
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Zip | 33026-4600
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KETANG MODI
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Credential | DO
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Telephone | 201-310-2957
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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 |
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License Number State |
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