Provider Demographics
NPI:1427187459
Name:PHYSICIANS IMAGING CENTER OF FLORIDA LLC
Entity Type:Organization
Organization Name:PHYSICIANS IMAGING CENTER OF FLORIDA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HERBERT
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:SHICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-964-3800
Mailing Address - Street 1:300 JERICHO QUADRANGLE WEST
Mailing Address - Street 2:SUITE 320
Mailing Address - City:JERICHO
Mailing Address - State:NY
Mailing Address - Zip Code:11753
Mailing Address - Country:US
Mailing Address - Phone:516-874-8108
Mailing Address - Fax:516-320-8952
Practice Address - Street 1:3800 JOHNSON STREET
Practice Address - Street 2:SUITE B
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021
Practice Address - Country:US
Practice Address - Phone:854-964-3800
Practice Address - Fax:516-320-8952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2014-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC64902085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty