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Organization
CHILDREN'S DIAGNOSTIC TESTING GROUP OF PALM BEACH, INC.
Active
Organization
CHILDREN'S DIAGNOSTIC TESTING GROUP OF PALM BEACH, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN E CIANCIULLI (PRESIDENT)
(305) 275-6069
Entity
Organization
Contact information
Practice address
3713 S CONGRESS AVE, LAKE WORTH, FL 33461-3753
(305) 275-6069
(305) 412-8265
Mailing address
9485 SW 72ND ST, SUITE A150, MIAMI, FL 33173-3242
(305) 275-6069
(305) 412-8265
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Enumeration date
05/22/2007
Last updated
09/11/2025
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