Provider Demographics
NPI:1437770450
Name:MOBILE MEDICAL SCANNER LLC
Entity Type:Organization
Organization Name:MOBILE MEDICAL SCANNER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDRES
Authorized Official - Middle Name:
Authorized Official - Last Name:GUARIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-918-8382
Mailing Address - Street 1:3911 SW 47TH AVE STE 901
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33314-2818
Mailing Address - Country:US
Mailing Address - Phone:954-918-8382
Mailing Address - Fax:
Practice Address - Street 1:3911 SW 47TH AVE STE 901
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33314-2818
Practice Address - Country:US
Practice Address - Phone:954-918-8382
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-30
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile