Southeastern Imaging, Inc

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

SOUTHEASTERN IMAGING, INC

Practice address

100 S Birch Rd Apt 1001
Fort Lauderdale, FL 33316-1542

Phone

(954) 343-3293

NPI assigned

Jul 26, 2017

Organization subpart

No

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

Authorized official

Name

Tea Kaganovich

Title

President

Phone

(954) 343-3293

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1501027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1501027200000",
    "number": "1669996195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 S BIRCH RD, STE 1001",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "33316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S BIRCH RD APT 1001",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333161542",
            "telephone_number": "954-343-3293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN IMAGING, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-26",
        "last_updated": "2017-07-26",
        "status": "A",
        "authorized_official_last_name": "KAGANOVICH",
        "authorized_official_first_name": "TEA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-343-3293"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2017; 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.