Provider Demographics
NPI:1487847992
Name:CAN-AM RADIOLOGY
Entity Type:Organization
Organization Name:CAN-AM RADIOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NORBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:DOMBROWSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DACBR
Authorized Official - Phone:561-624-6170
Mailing Address - Street 1:472 SW FUGE RD
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34997-6269
Mailing Address - Country:US
Mailing Address - Phone:772-781-2651
Mailing Address - Fax:
Practice Address - Street 1:472 SW FUGE RD
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34997-6269
Practice Address - Country:US
Practice Address - Phone:772-781-2651
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-20
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8308111NR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0200XChiropractic ProvidersChiropractorRadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========Medicaid