Ultracare Mobile Diagnostic Imaging LLC

Primary specialty

Sonography Radiologic TechnologistTaxonomy code 2471S1302X

License

57090 Issued in FL

Legal business name

ULTRACARE MOBILE DIAGNOSTIC IMAGING LLC

Practice address

4181 Iona St
Titusville, FL 32796-2222

Phone

(321) 795-7396

Fax

(321) 225-4936

NPI assigned

Sep 15, 2009

Last updated

Nov 18, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Deborah Y. Hazelbaker, RDMSNPI 1477782274

Title

Sole Proprietor

Phone

(321) 795-7396

Specialties & licenses 2

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Deborah Young Hazelbaker, R.D.M.S.

  • Other Specialist/Technologist
  • Titusville, FL
  • NPI 1477782274
  NPD Authorized official

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

{
    "created_epoch": "1252972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258502400000",
    "number": "1346573839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4181 IONA ST",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327962222",
            "telephone_number": "321-795-7396",
            "fax_number": "321-225-4936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4181 IONA ST",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327962222",
            "telephone_number": "321-795-7396",
            "fax_number": "321-225-4936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ULTRACARE MOBILE DIAGNOSTIC IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-15",
        "last_updated": "2009-11-18",
        "status": "A",
        "authorized_official_last_name": "HAZELBAKER",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "Y.",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "321-795-7396",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RDMS"
    },
    "taxonomies": [
        {
            "code": "2471S1302X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiologic Technologist, Sonography",
            "state": "FL",
            "license": "57090",
            "primary": true
        },
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": "FL",
            "license": "57090",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUSINESS LICENSE #",
            "identifier": "885043603",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pamela S Tronetti, DO
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• Desiree Trujillo
• Darryl Lee Trundle, CRNA
• Twisted Minds Counseling Center LLC
• Alyssa Chinyere Umeh
• Urgent Care Centers of Brevard County LLC (Health First AdventHealth Centra Care Titusville)
• Kathleen Rae Uvaro, L.M.T.
• Candice Maria Vaknin, MSN, APRN, FNP-C
• Heyoan Valdes Gonzalez, RBT

• Sonography Radiologic Technologist in Titusville, FL
• Providers in Titusville, FL by specialty
• Sonography Radiologic Technologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2009; 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.