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General NPI Number Information
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NPI Number | 1962489831
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Entity Type | Organization
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Legal Business Name | MOBILE RADIOLOGY & EKG SERVICE, INC
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Dates
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Enumeration Date | 12/30/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5405 NW 102ND AVE SUITE 243
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City | SUNRISE
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State | FL
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Zip | 33351-8746
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Country | US
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Telephone | 954-578-8390
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Fax | 954-578-0624
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Provider Business Mailing Address
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Address Line | PO BOX 17159
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City | CLEARWATER
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State | FL
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Zip | 33762-0159
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Country | US
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Telephone | 727-443-0389
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Fax | 727-442-7851
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. RANDALL W CARTWRIGHT
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Credential |
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Telephone | 727-443-0389
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335V00000X
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Taxonomy Name | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
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License Number | HCC6550
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License Number State | FL
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