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General NPI Number Information
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NPI Number | 1750566378
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Entity Type | Organization
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Legal Business Name | DIAGNOSTIC MD, LLC
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Dates
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Enumeration Date | 01/02/2008
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Last Update Date | 01/02/2008
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Provider Practice Location Address
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Address Line | 5245 SW 38TH AVE
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City | FT LAUDERDALE
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State | FL
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Zip | 33312-8227
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Country | US
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Telephone | 954-646-1212
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Fax |
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Provider Business Mailing Address
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Address Line | 5245 SW 38TH AVE
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City | FT LAUDERDALE
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State | FL
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Zip | 33312-8227
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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 | CEO
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Name | MICHAEL ROZENBERG
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Credential |
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Telephone | 954-646-1212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 247100000X
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Taxonomy Name | Radiologic Technologist
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License Number |
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License Number State |
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