Provider Demographics
NPI:1083649693
Name:REGIONAL MEDICAL IMAGING INC
Entity Type:Organization
Organization Name:REGIONAL MEDICAL IMAGING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DREW
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:MASLOWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-792-2236
Mailing Address - Street 1:7475 N. W. 4 ST.
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317
Mailing Address - Country:US
Mailing Address - Phone:954-792-2236
Mailing Address - Fax:954-792-2274
Practice Address - Street 1:7475 N. W. 4 ST.
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317
Practice Address - Country:US
Practice Address - Phone:954-792-2236
Practice Address - Fax:954-792-2274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2011-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonographyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL031797700Medicaid
FLE1600Medicare ID - Type Unspecified