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Organization
FORT LAUDERDALE MOBILE ULTRASOUND INC
Active
Organization
FORT LAUDERDALE MOBILE ULTRASOUND INC
Active
Other names
DPI of Plantation
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HOWARD S DEKKERS (CEO)
(954) 566-4551
Entity
Organization
Contact information
Practice address
7301 NW 4TH ST, SUITE 107, PLANTATION, FL 33317-2234
(954) 566-4551
(954) 566-4565
Mailing address
PO BOX 5286, FT LAUDERDALE, FL 33310-5286
(954) 566-4551
(954) 566-4565
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
—
—
261QR0200X
Radiology Clinic/Center
Primary
—
—
261QR0208X
Mobile Radiology Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0889591
AETNA
FL
01
—
V2156
BLUE CROSS BLUE SHIELD
FL
Enumeration date
07/11/2006
Last updated
11/15/2010
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