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General NPI Number Information
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NPI Number | 1861744823
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Entity Type | Organization
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Legal Business Name | DIAGNOSTIC MEDICAL IMAGING OF HOLLYWOOD LLC
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Dates
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Enumeration Date | 10/15/2012
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Last Update Date | 08/31/2022
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Provider Practice Location Address
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Address Line | 6517 TAFT STREET SUITE 103
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City | HOLLYWOOD
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State | FL
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Zip | 33024
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Country | US
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Telephone | 954-780-5566
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Fax | 954-780-5567
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Provider Business Mailing Address
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Address Line | 6517 TAFT STREET SUITE 103
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City | HOLLYWOOD
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State | FL
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Zip | 33024
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Country | US
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Telephone | 954-780-5566
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Fax | 954-780-5567
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ROBERT ISSA
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Credential |
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Telephone | 954-980-0398
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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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