Diagnostic Mobile X-Ray Inc

Primary specialty

Portable X-ray and/or Other Portable Diagnostic Imaging SupplierTaxonomy code 335V00000X

Legal business name

DIAGNOSTIC MOBILE X-RAY INC

Practice address

28100 Challenger Blvd
Suite 112
Punta Gorda, FL 33982

Phone

(941) 639-9729

Fax

(941) 639-5100

NPI assigned

Sep 19, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tzvi Wolf

Title

President

Phone

(718) 866-5591

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Portable X-ray supplier certification: CCN 10X0009936

Legal name

DIAGNOSTIC MOBILE X-RAY INC

Certification status

Active

Provider type (POS)

Portable X-ray supplier

Participating since

May 23, 2002

Last certification

Feb 2, 2023

Ownership / control type

Corporation

Facility address

28100 Challenger Blvd
Punta Gorda, FL 33982

Locations

Networks

• Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)
• Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Maximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754956800000",
    "number": "1104923614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28100 CHALLENGER BLVD",
            "address_2": "SUITE 112",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "33982",
            "telephone_number": "941-639-9729",
            "fax_number": "941-639-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28100 CHALLENGER BLVD",
            "address_2": "SUITE 112",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "33982",
            "telephone_number": "941-639-9729",
            "fax_number": "941-639-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAGNOSTIC MOBILE X-RAY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-19",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A",
        "authorized_official_last_name": "WOLF",
        "authorized_official_first_name": "TZVI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-866-5591"
    },
    "taxonomies": [
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "510029100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kevin Demello, APRN
• Ken Franklin Denman, ARNP
• Suzy Desio, LMHC
• Desoto ABA Services Corp
• Jordan Kimberly Desruisseaux, PA-C
• Angel Reinaldo Diaz Alvarez
• Yeima Diaz Alvarez
• Liena Diaz Luaces, APRN
• Claudia Diaz
• Douglas H Joyce DO PA

• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Punta Gorda, FL
• Providers in Punta Gorda, FL by specialty
• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.