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General NPI Number Information
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NPI Number | 1750388278
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Entity Type | Organization
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Legal Business Name | BMDMOBILE
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Dates
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Enumeration Date | 06/29/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3109 GRAND AVE #437
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City | COCONUT GROVE
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State | FL
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Zip | 33133-5103
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Country | US
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Telephone | 305-332-6151
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Fax |
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Provider Business Mailing Address
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Address Line | 3109 GRAND AVE #437
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City | COCONUT GROVE
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State | FL
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Zip | 33133-5103
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Country | US
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Telephone | 305-332-6151
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHRISTOPHER HANCOCK
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Credential | M.D.
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Telephone | 305-332-6151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2471B0102X
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Taxonomy Name | Bone Densitometry Radiologic Technologist
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License Number | 00026813
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License Number State | AL
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