MEDICARE: REMBRANDT MOBILE DIAGNOSTICS INC

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	293D00000X	Physiological Laboratory

General Provider Information

NPI Number	:	1578885950
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REMBRANDT MOBILE DIAGNOSTICS INC

Provider Business Mailing Address
First Line	:	2717 W CYPRESS CREEK RD
Second Line	:	SUITE 800
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-1703
Country	:	US
Telephone Number	:	954-862-2246
Fax Number	:	954-862-2247

Provider Business Practice Location Address
First Line	:	2717 W CYPRESS CREEK RD
Second Line	:	SUITE 800
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-1703
Country	:	US
Telephone Number	:	954-862-2246
Fax Number	:	954-862-2247

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JAMES I WARSAGER
Credential	:	R.T.
Telephone Number	:	954-862-2246

Provider Enumeration Date	:	02/25/2010
Last Update Date	:	06/22/2011

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