Provider Demographics
NPI:1265638894
Name:ONSITE DIAGNOSTICS OF AMERICA, INC
Entity Type:Organization
Organization Name:ONSITE DIAGNOSTICS OF AMERICA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ARLAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HALLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:954-749-2800
Mailing Address - Street 1:7501 W OAKLAND PARK BLVD
Mailing Address - Street 2:SUITE 305
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33319-4982
Mailing Address - Country:US
Mailing Address - Phone:954-749-2800
Mailing Address - Fax:954-749-2890
Practice Address - Street 1:7501 W OAKLAND PARK BLVD
Practice Address - Street 2:SUITE 305
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33319-4982
Practice Address - Country:US
Practice Address - Phone:954-749-2800
Practice Address - Fax:954-749-2890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-21
Last Update Date:2009-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
246ZE0600X
FL2471V0106X, 291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Multi-Specialty
No2471V0106XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular-Interventional TechnologyGroup - Multi-Specialty
No291U00000XLaboratoriesClinical Medical LaboratoryGroup - Multi-Specialty