Moblie Diagnostic Imaging Inc.

Primary specialty

Mobile Radiology Clinic/CenterTaxonomy code 261QR0208X

License

HCC6340 Issued in FL

Legal business name

MOBLIE DIAGNOSTIC IMAGING INC.

Practice address

12555 Orange Dr
Suite 101
Davie, FL 33330-4304

Phone

(954) 452-5638

Fax

(954) 452-5639

NPI assigned

Jul 19, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Brad Kantor

Title

Owner/President

Phone

(954) 452-5638

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462492800000",
    "number": "1275532632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 550819",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333550819",
            "telephone_number": "954-452-5638",
            "fax_number": "954-452-5639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12555 ORANGE DR",
            "address_2": "SUITE 101",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333304304",
            "telephone_number": "954-452-5638",
            "fax_number": "954-452-5639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBLIE DIAGNOSTIC IMAGING INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-19",
        "last_updated": "2016-05-06",
        "status": "A",
        "authorized_official_last_name": "KANTOR",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "954-452-5638",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": "FL",
            "license": "HCC6340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2016; 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.