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General NPI Number Information
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NPI Number | 1952404519
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Entity Type | Organization
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Legal Business Name | PALM BEACH BROWARD MEDICAL IMAGING CENTER, INC.
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Dates
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Enumeration Date | 09/07/2006
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Last Update Date | 11/10/2015
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Provider Practice Location Address
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Address Line | 1500 E HILLSBORO BLVD SUITE 110
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City | DEERFIELD BEACH
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State | FL
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Zip | 33441-4356
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Country | US
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Telephone | 954-426-3006
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Fax | 954-481-9318
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Provider Business Mailing Address
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Address Line | 1500 E HILLSBORO BLVD SUITE 110
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City | DEERFIELD BEACH
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State | FL
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Zip | 33441-4356
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Country | US
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Telephone | 954-426-3006
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Fax | 954-481-9318
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Authorized Official
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Title or Position | OWNER/MEDICAL DIRECTOR
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Name | KAYA COLAK
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Credential | M.D.
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Telephone | 954-426-3006
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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 | HCC3645
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License Number State | FL
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