# MEDICUS DIAGNOSTIC INC

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

## Provider details

- **NPI number:** 1457515793
- **Authorized official:** FERNANDO LOPEZ-IVERN (OWNER)
- **Authorized official phone:** (561) 893-0655

## Contact information

- **Practice address:** 9980 CENTRAL PARK BLVD N, SUITE 116, BOCA RATON, FL 33428-1762
- **Practice address phone:** (561) 208-5515
- **Mailing address:** 9980 CENTRAL PARK BLVD N, SUITE 116, BOCA RATON, FL 33428-1762

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 335V00000X | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | — | NULL | Yes |

## Other

- **Enumeration date:** 07/16/2008
- **Last updated:** 04/25/2012