MEDICARE: HENDLEY DIAGNOSTICS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2471S1302X	Sonography Radiologic Technologist

General Provider Information

NPI Number	:	1265703037
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HENDLEY DIAGNOSTICS

Provider Business Mailing Address
First Line	:	426 9TH AVE
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32962-1542
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	426 9TH AVE
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32962-1542
Country	:	US
Telephone Number	:	772-569-7861
Fax Number	:

Authorized Official
Title or Position	:	CARDIOVASCULAR TECHNOLOGIST
Name	:	MAURICE HENDLEY
Credential	:	RCS
Telephone Number	:	772-569-7861

Provider Enumeration Date	:	01/25/2012
Last Update Date	:	01/25/2012

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