Provider Demographics
NPI:1083024160
Name:SOUTH FLORIDA DIAGNOSTIC GROUP, LLC
Entity Type:Organization
Organization Name:SOUTH FLORIDA DIAGNOSTIC GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:DR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:ZUSMER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:305-389-9040
Mailing Address - Street 1:PO BOX 823023
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33082-3023
Mailing Address - Country:US
Mailing Address - Phone:305-389-9040
Mailing Address - Fax:954-208-0934
Practice Address - Street 1:12550 BISCAYNE BLVD
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-2541
Practice Address - Country:US
Practice Address - Phone:305-389-9040
Practice Address - Fax:954-208-0934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-29
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty