Provider Demographics
NPI:1063498426
Name:REMBRANDT MOBILE DIAGNOSTICS INC
Entity Type:Organization
Organization Name:REMBRANDT MOBILE DIAGNOSTICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:I
Authorized Official - Last Name:WARSAGER
Authorized Official - Suffix:
Authorized Official - Credentials:R T
Authorized Official - Phone:954-862-2246
Mailing Address - Street 1:2717 W CYPRESS CREEK RD
Mailing Address - Street 2:SUITE 800
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-1703
Mailing Address - Country:US
Mailing Address - Phone:954-862-2246
Mailing Address - Fax:954-862-2247
Practice Address - Street 1:2717 W CYPRESS CREEK RD
Practice Address - Street 2:SUITE 800
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-1703
Practice Address - Country:US
Practice Address - Phone:954-862-2246
Practice Address - Fax:954-862-2247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-19
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL109946335V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00235409OtherMEDICARE RAILROAD
P00235409OtherMEDICARE RAILROAD