# BROADER MRI OF PALM BEACH LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376224956
- **Authorized official:** MANUEL IRIBAR MD (OWNER)
- **Authorized official phone:** (561) 766-0304

## Contact information

- **Practice address:** 5405 OKEECHOBEE BLVD \#100, WEST PALM BEACH, FL 33417
- **Practice address phone:** (561) 766-0304
- **Practice address fax:** (305) 768-9164
- **Mailing address:** 5405 OKEECHOBEE BLVD \#100, WEST PALM BEACH, FL 33417
- **Mailing address phone:** (561) 766-0304
- **Mailing address fax:** (305) 768-9164

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | — | NULL | — |
| 111N00000X | Chiropractor | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 2085B0100X | Body Imaging Physician | — | NULL | Yes |
| 2085B0100X | Body Imaging Physician | — | — | Yes |
| 2085R0202X | Diagnostic Radiology Physician | — | NULL | — |
| 2085R0202X | Diagnostic Radiology Physician | — | — | — |

## Other

- **Enumeration date:** 07/27/2023
- **Last updated:** 09/13/2023