Organization
PINES IMAGING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN CHAN-A-SUE (GM)
(954) 530-8824
Entity
Organization
Contact information
Practice address
9696 PINES BLVD, PEMBROKE PINES, FL 33024-6246
(954) 530-8824
(954) 530-8819
Mailing address
9696 PINES BLVD, PEMBROKE PINES, FL 33024-6246
(954) 530-8824
(954) 530-8819
Taxonomy
Speciality
Code
Description
License number
State
2471M1202X
Magnetic Resonance Imaging Radiologic Technologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G16000010749
STATE REGISTRATION NUMBER
FL
Enumeration date
09/16/2016
Last updated
09/16/2016
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