Provider Demographics
NPI:1760716450
Name:MDI CONSULTING GROUP, INC.
Entity Type:Organization
Organization Name:MDI CONSULTING GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAYNE
Authorized Official - Middle Name:MAY
Authorized Official - Last Name:MONTROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-862-1432
Mailing Address - Street 1:12555 ORANGE DR
Mailing Address - Street 2:SUITE 230
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33330-4304
Mailing Address - Country:US
Mailing Address - Phone:954-862-1432
Mailing Address - Fax:954-862-1437
Practice Address - Street 1:12555 ORANGE DR
Practice Address - Street 2:SUITE 230
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33330-4304
Practice Address - Country:US
Practice Address - Phone:954-862-1432
Practice Address - Fax:954-862-1437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-28
Last Update Date:2010-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261QR0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile