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General NPI Number Information
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NPI Number | 1598570798
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Entity Type | Organization
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Legal Business Name | MAMMOCARE, LLC
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Dates
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Enumeration Date | 02/12/2025
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Last Update Date | 02/16/2025
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Provider Practice Location Address
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Address Line | 6821 NW 11TH PL
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City | GAINESVILLE
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State | FL
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Zip | 32605-4216
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Country | US
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Telephone | 352-999-3553
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Fax |
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Provider Business Mailing Address
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Address Line | 14191 NW 166TH TER UNIT 2
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City | ALACHUA
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State | FL
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Zip | 32615-8173
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Country | US
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Telephone | 319-535-0465
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SHAFIK N WASSEF
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Credential | MD
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Telephone | 319-535-0465
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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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Taxonomy #2
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Taxonomy Code | 261QR0206X
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Taxonomy Name | Mammography Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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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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