MEDICARE: SOUTH BROWARD IMAGING LLC

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	2085R0202X	Diagnostic Radiology Physician

General Provider Information

NPI Number	:	1386497154
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTH BROWARD IMAGING LLC

Provider Business Mailing Address
First Line	:	6517 TAFT ST STE 103
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-4063
Country	:	US
Telephone Number	:	786-732-2380
Fax Number	:

Provider Business Practice Location Address
First Line	:	6517 TAFT ST STE 103
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-4063
Country	:	US
Telephone Number	:	786-732-2380
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ANTONIO ALVAREZ
Credential	:	DC
Telephone Number	:	786-732-2380

Provider Enumeration Date	:	04/10/2024
Last Update Date	:	04/10/2024

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Directions to “SOUTH BROWARD IMAGING LLC ” Practice Location

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