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General NPI Number Information
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NPI Number | 1548184823
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Entity Type | Organization
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Legal Business Name | BROADER MRI OF STUART, LLC
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Dates
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Enumeration Date | 08/07/2026
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Last Update Date | 08/07/2026
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Provider Practice Location Address
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Address Line | 798 SW FEDERAL HIGHWAY
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City | STUART
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State | FL
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Zip | 34994
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Country | US
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Telephone | 772-241-3224
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Fax |
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Provider Business Mailing Address
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Address Line | 13297 MAJESTIC WAY
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City | COOPER CITY
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State | FL
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Zip | 33330-2657
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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 | OWNER
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Name | DR. JORGE MODESTO IRIBAR
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Credential | DC
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Telephone | 954-529-1083
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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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