MMDS FL Idtf

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

Legal business name

MMDS FL IDTF

Practice address

4707 Enterprise Ave
Suite 7
Naples, FL 34104-7064

Phone

(423) 480-4087

NPI assigned

Feb 10, 2016

Organization subpart

Yes

Parent organization

MMDS OF NORTH CAROLINA, INCAs reported in NPPES

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

Authorized official

Name

Amy Brookman

Title

Corporate Business Development

Phone

(423) 480-4087

Specialties & licenses 1

Addresses

Other names 1

• MMDS Mobile X-Ray IDTF Doing business as

Part of

National Mobile X-Ray

Locations

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

{
    "created_epoch": "1455062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455062400000",
    "number": "1821456492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3011 HARRAH DR",
            "address_2": "SUITE L",
            "city": "SPRING HILL",
            "state": "TN",
            "postal_code": "371746252",
            "telephone_number": "423-480-4087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4707 ENTERPRISE AVE",
            "address_2": "SUITE 7",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341047064",
            "telephone_number": "423-480-4087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MMDS FL IDTF",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MMDS OF NORTH CAROLINA, INC",
        "enumeration_date": "2016-02-10",
        "last_updated": "2016-02-10",
        "status": "A",
        "authorized_official_last_name": "BROOKMAN",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "CORPORATE BUSINESS DEVELOPMENT",
        "authorized_official_telephone_number": "423-480-4087"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MMDS Mobile X-Ray IDTF",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nithya Mitta, MD
• Jasmine Rose Mius
• Constance M Mix, R.N.
• Shemnon Z Miyamoto, CRNA
• Naomi Mizrachi, LM, CPM
• Ana Moas
• Mobile Anesthesia Solutions, LLC
• Mobile Anesthesiologists of Florida, Inc.
• Mobile ASC, LLC
• Mobile Cardiovascular Imaging LLC

• Physiological Laboratory in Naples, FL
• Providers in Naples, FL by specialty
• Physiological Laboratory in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.