Provider Demographics
NPI:1083676175
Name:OMI CT OF FORT LAUDERDALE INC
Entity Type:Organization
Organization Name:OMI CT OF FORT LAUDERDALE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BABITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-888-6411
Mailing Address - Street 1:2200 N COMMERCE PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326
Mailing Address - Country:US
Mailing Address - Phone:954-888-6411
Mailing Address - Fax:954-888-6414
Practice Address - Street 1:841 E COMMERCIAL BLVD
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33334
Practice Address - Country:US
Practice Address - Phone:954-229-3998
Practice Address - Fax:954-229-1903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-04
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology