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General NPI Number Information
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NPI Number | 1538334016
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Entity Type | Organization
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Legal Business Name | ADVANCED X-RAY ANALYSIS INC
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Dates
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Enumeration Date | 04/25/2008
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Last Update Date | 04/25/2008
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Provider Practice Location Address
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Address Line | 4661 JOHNSON RD UNIT 4
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City | COCONUT CREEK
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State | FL
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Zip | 33073-4363
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Country | US
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Telephone | 954-426-1897
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Fax | 954-426-1899
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Provider Business Mailing Address
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Address Line | PO BOX 970561
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City | COCONUT CREEK
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State | FL
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Zip | 33097-0561
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Country | US
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Telephone | 954-426-1897
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Fax | 954-426-1899
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID K POCES
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Credential | D.R.
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Telephone | 954-426-1897
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | CH4400
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License Number State | FL
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