MEDICARE: SKYNAR DIAGNOSTICS 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	2471V0105X	Vascular Sonography Radiologic Technologist

General Provider Information

NPI Number	:	1962223974
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SKYNAR DIAGNOSTICS LLC

Provider Business Mailing Address
First Line	:	316 CALLIOPE ST
Second Line	:
City	:	OCOEE
State	:	FL
Zip	:	34761-4616
Country	:	US
Telephone Number	:	407-409-6343
Fax Number	:

Provider Business Practice Location Address
First Line	:	6235 SAN PABLO AVE
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94608
Country	:	US
Telephone Number	:	407-409-6343
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	QUYEN DUONG
Credential	:
Telephone Number	:	407-409-6343

Provider Enumeration Date	:	10/22/2024
Last Update Date	:	10/22/2024

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Directions to “SKYNAR DIAGNOSTICS LLC ” Practice Location

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