Organization Active NPI

Med Tech Imaging, Inc.

  • Physiological Laboratory
  • Fort Lauderdale, FL
National Provider Identifier
1780767012
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physiological LaboratoryTaxonomy code 293D00000X
Legal business name
MED TECH IMAGING, INC.
Practice address
2000 E Sunrise Blvd
Fort Lauderdale, FL 33304-3044
Phone
(954) 766-6060
Fax
(954) 341-3400
NPI assigned
Oct 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Randall Auclair
Title
President
Phone
(954) 766-6060

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physiological Laboratory 293D00000X Primary

Addresses

Primary practice location

2000 E Sunrise Blvd
Fort Lauderdale, FL 33304-3044

Mailing address

2000 E Sunrise Blvd
Fort Lauderdale, FL 33304-3044
Phone (954) 766-6060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060217000353 FL Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 6103831730 Practice locations: Ft Lauderdale, FL

National Provider Directory

National Provider Directory

Locations

315 NE 3rd Ave
Ste 201
Ft Lauderdale, FL 33301
Phone (954) 766-6060

2000 E Sunrise Blvd
Ste B
Ft Lauderdale, FL 33304
Phone (954) 766-6060

2000 E Sunrise Blvd
Ft Lauderdale, FL 33304
Phone (954) 766-6060

2000 E Sunrise Blvd
#B
Ft Lauderdale, FL 33304

729 E Atlantic Blvd
Pompano Beach, FL 33060
Phone (855) 920-2377

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1780767012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 E SUNRISE BLVD",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333043044",
            "telephone_number": "954-766-6060",
            "fax_number": "954-341-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 E SUNRISE BLVD",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333043044",
            "telephone_number": "954-766-6060",
            "fax_number": "954-341-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED TECH IMAGING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "AUCLAIR",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-766-6060",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.