Provider Demographics
NPI:1265468870
Name:SHERIDAN MRI & DIAGNOSTICS, LLC
Entity Type:Organization
Organization Name:SHERIDAN MRI & DIAGNOSTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JILL
Authorized Official - Middle Name:KLASKIN
Authorized Official - Last Name:PRESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-460-3114
Mailing Address - Street 1:4350 SHERIDAN ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-3556
Mailing Address - Country:US
Mailing Address - Phone:954-987-3333
Mailing Address - Fax:954-981-9655
Practice Address - Street 1:4350 SHERIDAN ST
Practice Address - Street 2:SUITE 102
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3556
Practice Address - Country:US
Practice Address - Phone:954-987-3333
Practice Address - Fax:954-981-9655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1192261QM1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)