Provider Demographics
NPI:1053320077
Name:SONOIMAGING, INC.
Entity Type:Organization
Organization Name:SONOIMAGING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:VIRGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-586-4747
Mailing Address - Street 1:2500 QUANTUM LAKES DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-8324
Mailing Address - Country:US
Mailing Address - Phone:561-586-4747
Mailing Address - Fax:561-586-1119
Practice Address - Street 1:2500 QUANTUM LAKES DR
Practice Address - Street 2:SUITE 203
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-8324
Practice Address - Country:US
Practice Address - Phone:561-586-4747
Practice Address - Fax:561-586-1119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular SonographyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE6300Medicare ID - Type Unspecified