BROWARD PET IMAGING CENTER LLC NPI 1588623904

NPI Information

NPI: 1588623904
Provider Name: BROWARD PET IMAGING CENTER LLC
Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

Address:
4850 WEST OAKLAND PARK BLVD
SUITE 1A
LAUDERDALE LAKES, FL
ZIP 33313
Phone: (954) 735-6330
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BROWARD PET IMAGING CENTER LLC is a diagnostic radiology radiology in Lauderdale Lakes, FL. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. BROWARD PET IMAGING CENTER LLC NPI is 1588623904. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4850 WEST OAKLAND PARK BLVD
SUITE 1A
LAUDERDALE LAKES, FL
ZIP 33313
Phone: (954) 735-6330
Fax: (975) 739-1924

The provider's authorized official is Edward A Dauer .
The authorized official title is Managing Member and has the following contact phone number (954) 739-0978.

The enumeration date for this NPI number is 3/23/2006 and was last updated on 7/11/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085R0202X	Radiology	Diagnostic Radiology			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	AK219	MEDICARE PIN	FLORIDA
2	264327800	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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