Tri County Pet LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

License

HCC5507 Issued in FL

Legal business name

TRI COUNTY PET LLC

Practice address

1150 N 35TH Ave
Suite 665
Hollywood, FL 33021-5424

Phone

(954) 981-6668

Fax

(954) 981-5944

NPI assigned

Aug 15, 2005

Organization subpart

No

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

Authorized official

Name

Lisette Cruz-Deno

Title

Managing Director

Phone

(954) 981-6668

Specialties & licenses 1

Addresses

Other names 1

• PET Imaging Institute of South Florida Doing business as

Medicare fee-for-service enrollment

Enrolled in FL, TX2 enrollments

Enrollment records 2

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Tri County Pet LLC

  • Radiology Clinic/Center
  • Fort Lauderdale, FL
  • NPI 1003318049

  O20120206000581

  Same enrollment
• Tri County Pet LLC

  • Radiology Clinic/Center
  • Pembroke Pines, FL
  • NPI 1760602510

  O20120206000581

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Networks

• HealthSun Health Plans Network

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Tri County Pet LLC

  • Radiology Clinic/Center
  • Pembroke Pines, FL
  • NPI 1760602510
  NPPES parent name

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Karen L Ayres, MD

  • Diagnostic Radiology Physician
  • Hollywood, FL
  • NPI 1811966567
  Medicare reassignment Care Compare group NPD
• Barry Charnick, MD

  • Nuclear Radiology Physician
  • Ft Lauderdale, FL
  • NPI 1700889912

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• David Hodge, M.D.

  • Diagnostic Radiology Physician
  • Hollywood, FL
  • NPI 1932102183
  Medicare reassignment Care Compare group NPD
• Neetha Gandikota, MD

  • Diagnostic Radiology Physician
  • New York, NY
  • NPI 1073804621

  FL, TX

  Medicare reassignment Care Compare group NPD
• Barbara Raphael, MD

  • Diagnostic Radiology Physician
  • Hollywood, FL
  • NPI 1871801126
  Medicare reassignment Care Compare group
• Scott Skorupa, M.D.

  • Diagnostic Radiology Physician
  • Hollywood, FL
  • NPI 1033115233
  Medicare reassignment NPD

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386806400000",
    "number": "1124020656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 N 35TH AVE",
            "address_2": "SUITE 665",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215424",
            "telephone_number": "954-981-6668",
            "fax_number": "954-981-5944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 N 35TH AVE",
            "address_2": "SUITE 665",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215424",
            "telephone_number": "954-981-6668",
            "fax_number": "954-981-5944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI COUNTY PET LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-15",
        "last_updated": "2013-12-12",
        "status": "A",
        "authorized_official_last_name": "CRUZ-DENO",
        "authorized_official_first_name": "LISETTE",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "954-981-6668"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "FL",
            "license": "HCC5507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PET Imaging Institute of South Florida",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Daniela Edith Treitl, M.D.
• Ingris Treminio, MS OT
• Grisel Valladares Treto, ARNP
• Anastasiya Tretyakova
• Diane Katherine Trevena, ARNP
• Tri-County Homecare of Florida, Inc.
• Tri-County Medical Care , LLC
• James Hernan Triana Jr., PH.D., L.C.S.W.
• Kether Kali Trice
• Trident Laboratories Inc

• Radiology Clinic/Center in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Radiology Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.