1659335503 NPI number — BEST IMAGING GROUP INC

Table of content: (NPI 1659335503)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659335503 NPI number — BEST IMAGING GROUP INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BEST IMAGING GROUP INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1659335503
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/21/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 30566
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FT LAUDERDALE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33303-0566
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-946-3433
Provider Business Mailing Address Fax Number:
954-946-3464

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
601 E SAMPLE RD
Provider Second Line Business Practice Location Address:
SUITE 103
Provider Business Practice Location Address City Name:
POMPANO BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33064-4443
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-946-3433
Provider Business Practice Location Address Fax Number:
954-946-3464
Provider Enumeration Date:
04/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
QUADARA
Authorized Official First Name:
DANIEL
Authorized Official Middle Name:
M
Authorized Official Title or Position:
OWNER/PRESIDENT
Authorized Official Telephone Number:
954-946-3433

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X , with the licence number:  AHCA# 5676 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: V2545 . This is a "BLUECROSS/BLUESHIELD" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 1740 . This is a "TOTAL HEALTH CHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 191103 . This is a "HEALTHEASE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: P00078482 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: V2545 . This is a "HEALTH OPTIONS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 2080866 . This is a "FIRST HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1041052 . This is a "CAREPLUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 191103 . This is a "WELLCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 191103 . This is a "STAYWELL" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 41002 . This is a "NEIGHBORHOOD HEALTH" identifier . This identifiers is of the category "OTHER".




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