Provider Demographics
NPI:1841240595
Name:HALLANDALE IMAGING&DIAGNOSTIC, INC.
Entity Type:Organization
Organization Name:HALLANDALE IMAGING&DIAGNOSTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YURY
Authorized Official - Middle Name:
Authorized Official - Last Name:SKARLAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-496-4181
Mailing Address - Street 1:1250 E HALLANDALE BEACH BLVD
Mailing Address - Street 2:SUITE 1005-2
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-4634
Mailing Address - Country:US
Mailing Address - Phone:954-457-1308
Mailing Address - Fax:954-449-6469
Practice Address - Street 1:1250 E HALLANDALE BEACH BLVD
Practice Address - Street 2:SUITE 1005-2
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-4634
Practice Address - Country:US
Practice Address - Phone:954-457-1308
Practice Address - Fax:954-449-6469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Single Specialty