National P E T Scan Broward LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

License

HCC5688 Issued in FL

Legal business name

NATIONAL P E T SCAN BROWARD LLC

Practice address

6290 N Federal Hwy
Ft Lauderdale, FL 33308-1917

Phone

(954) 332-3000

Fax

(954) 332-2671

NPI assigned

May 24, 2005

Organization subpart

No

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

Authorized official

Name

Ms. Margie Faye Austin

Title

Administrative Assistant

Phone

(904) 358-8441

Specialties & licenses 1

Addresses

Other identifiers 11

Locations

Practitioners 2

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

• Howard Kirby Blankenship, MD

  • Vascular & Interventional Radiology Physician
  • St Petersburg, FL
  • NPI 1851300446

  Diagnostic Radiology

  NPD (past)
• Larry H Wilf, M.D.

  • Nuclear Radiology Physician
  • Tampa, FL
  • NPI 1508824608

  Diagnostic Radiology

  NPD (past)

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354665600000",
    "number": "1194728014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6622 SOUTHPOINT DR S",
            "address_2": "SUITE 360",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168014",
            "telephone_number": "904-358-8441",
            "fax_number": "904-358-2288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6290 N FEDERAL HWY",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333081917",
            "telephone_number": "954-332-3000",
            "fax_number": "954-332-2671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATIONAL P E T SCAN BROWARD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-24",
        "last_updated": "2012-12-05",
        "status": "A",
        "authorized_official_last_name": "AUSTIN",
        "authorized_official_first_name": "MARGIE",
        "authorized_official_middle_name": "FAYE",
        "authorized_official_title_or_position": "ADMINISTRATIVE ASSISTANT",
        "authorized_official_telephone_number": "904-358-8441",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "FL",
            "license": "HCC5688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "196704",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA - HMO",
            "identifier": "2630670",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "593688943",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD RETIREM",
            "identifier": "CK2451",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD",
            "identifier": "38830",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FOUNDATION",
            "identifier": "67826",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD FL",
            "identifier": "V2274",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "593688943",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VISTA",
            "identifier": "SG011169",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6958176-001",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA - PPO",
            "identifier": "7441285",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• National Durable Medical Equipment
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• National Medical Depot LLC
• National Physicians Group, LLC
• National Vision Inc
• Natnow DPM
• Natural Medicine
• Naturally You Skin & Body Clinic. Inc

• Radiology Clinic/Center in Ft Lauderdale, FL
• Providers in Ft Lauderdale, 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 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.