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General NPI Number Information
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NPI Number | 1801040472
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Entity Type | Organization
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Legal Business Name | ON-SITE CARDIAC IMAGING CORP
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Dates
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Enumeration Date | 11/10/2008
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Last Update Date | 11/10/2008
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Provider Practice Location Address
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Address Line | 3380 FAIRLANE FARMS RD SUITE 6
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City | WELLINGTON
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State | FL
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Zip | 33414-8764
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Country | US
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Telephone | 561-252-8364
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Fax | 561-333-6671
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Provider Business Mailing Address
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Address Line | 3380 FAIRLANE FARMS RD SUITE 6
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City | WELLINGTON
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State | FL
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Zip | 33414-8764
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Country | US
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Telephone | 561-252-8364
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Fax | 561-333-6671
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. KAY KASSEL
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Credential |
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Telephone | 561-252-8364
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0404X
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Taxonomy Name | Cardiac Rehabilitation Clinic/Center
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License Number | HCC8298
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number | HCC8298
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License Number State | FL
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