Organization
PINES DIAGNOSTIC TESTING GROUP 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
11011 SHERIDAN ST, SUITE 101, HOLLYWOOD, FL 33026-1505
(954) 443-8010
(305) 412-8265
Mailing address
11011 SHERIDAN ST, SUITE 101, HOLLYWOOD, FL 33026-1505
(954) 443-8010
(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
03/12/2007
Last updated
05/13/2008
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