Organization
PORTABLE MEDICAL DIAGNOSTICS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANDREW ROSEBROUGH BSA (VP, CFO)
(561) 964-3311
Entity
Organization
Contact information
Practice address
3540 FOREST HILL BLVD STE 112, WEST PALM BEACH, FL 33406-5878
(561) 964-3311
(561) 964-3199
Mailing address
3540 FOREST HILL BLVD STE 112, WEST PALM BEACH, FL 33406-5878
(561) 964-3311
(561) 964-3199
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
HCC4152
FL
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008374300
—
FL
01
—
W9857
MEDICARE PROVIDER NUMBER
FL
Enumeration date
11/26/2013
Last updated
04/04/2024
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