Provider Demographics
NPI:1639245152
Name:BRITISH DIAGNOSTIC INSTITUTE
Entity Type:Organization
Organization Name:BRITISH DIAGNOSTIC INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:J
Authorized Official - Last Name:GOULET
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-439-3165
Mailing Address - Street 1:1600 S FEDERAL HWY
Mailing Address - Street 2:SUITE 820
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062-7500
Mailing Address - Country:US
Mailing Address - Phone:954-786-5259
Mailing Address - Fax:954-772-3625
Practice Address - Street 1:1600 S FEDERAL HWY
Practice Address - Street 2:SUITE 820
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-7500
Practice Address - Country:US
Practice Address - Phone:954-786-5259
Practice Address - Fax:954-772-3625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
40913OtherBCBS FL
4115620001OtherPGBA
40913AMedicare ID - Type Unspecified
40913Medicare ID - Type Unspecified