Organization
HOLLYWOOD MOBILE DIAGNOSTICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC SHARENOW (OWNER PRESIDENT)
(954) 965-0054
Entity
Organization
Contact information
Practice address
2216 N 20TH AVE, HOLLYWOOD, FL 33020-2108
(954) 965-0054
(954) 965-5967
Mailing address
2216 N 20TH AVE, HOLLYWOOD, FL 33020-2108
(954) 965-0054
(954) 965-5967
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
—
—
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
510063100
—
FL
Enumeration date
11/07/2006
Last updated
06/05/2008
Update your record
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