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NPI Code Detail

MEDICARE: MED TECH IMAGING, INC.

MEDICARE: MED TECH IMAGING, 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
1293D00000XPhysiological Laboratory

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1780767012
Entity Type Code : Organization
Provider Name (Legal Business Name) : MED TECH IMAGING, INC.
Provider Business Mailing Address
First Line : 2000 E SUNRISE BLVD
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33304-3044
Country : US
Telephone Number : 954-766-6060
Fax Number : 954-341-3400
Provider Business Practice Location Address
First Line : 2000 E SUNRISE BLVD
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33304-3044
Country : US
Telephone Number : 954-766-6060
Fax Number : 954-341-3400
Authorized Official
Title or Position : PRESIDENT
Name : MR. RANDALL AUCLAIR
Credential :
Telephone Number : 954-766-6060
Provider Enumeration Date : 10/23/2006
Last Update Date : 08/22/2020

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Directions to “MED TECH IMAGING, INC. ” Practice Location

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