Provider Demographics
NPI:1790703254
Name:DIATECHNOLOGY INC
Entity Type:Organization
Organization Name:DIATECHNOLOGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JUN
Authorized Official - Middle Name:HWAN
Authorized Official - Last Name:CHOI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-464-5217
Mailing Address - Street 1:2831 N FEDERAL HWY
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-6809
Mailing Address - Country:US
Mailing Address - Phone:866-464-5217
Mailing Address - Fax:866-464-5218
Practice Address - Street 1:2831 N FEDERAL HWY
Practice Address - Street 2:SUITE 2
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-6809
Practice Address - Country:US
Practice Address - Phone:866-464-5217
Practice Address - Fax:866-464-5218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5515780001Medicare NSC