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General NPI Number Information
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NPI Number | 1851764658
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Entity Type | Organization
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Legal Business Name | WELLNESS DIAGNOSTICS SERVICES INC
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Dates
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Enumeration Date | 11/03/2015
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Last Update Date | 11/03/2015
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Provider Practice Location Address
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Address Line | 1856 N NOB HILL RD SUITE #172
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City | PLANTATION
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State | FL
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Zip | 33322-6548
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Country | US
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Telephone | 678-596-5328
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Fax |
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Provider Business Mailing Address
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Address Line | 1856 N NOB HILL RD SUITE #172
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City | PLANTATION
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State | FL
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Zip | 33322-6548
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Country | US
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Telephone | 678-596-5328
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LORI RUBIN
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Credential |
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Telephone | 678-596-5328
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number |
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License Number State |
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