Provider Demographics
NPI:1518159482
Name:HARBOUR DIAGNOSTIC IMAGING
Entity Type:Organization
Organization Name:HARBOUR DIAGNOSTIC IMAGING
Other - Org Name:HARBOUR VIEW DIAGNOSTIC IMAGING
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVEROS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-294-8735
Mailing Address - Street 1:2401 PGA BLVD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410
Mailing Address - Country:US
Mailing Address - Phone:561-932-0788
Mailing Address - Fax:561-932-0799
Practice Address - Street 1:2401 PGA BLVD
Practice Address - Street 2:SUITE 130
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410
Practice Address - Country:US
Practice Address - Phone:561-932-0788
Practice Address - Fax:561-932-0799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-15
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology