Provider Demographics
NPI:1841245727
Name:FLORIDA FLUOROSCOPY SERVICES LTD
Entity Type:Organization
Organization Name:FLORIDA FLUOROSCOPY SERVICES LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:MR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:STACY
Authorized Official - Last Name:SCROGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:561-630-6277
Mailing Address - Street 1:1471 CADES BAY AVE
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-5301
Mailing Address - Country:US
Mailing Address - Phone:561-630-6277
Mailing Address - Fax:561-630-6062
Practice Address - Street 1:1471 CADES BAY AVE
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-5301
Practice Address - Country:US
Practice Address - Phone:561-630-6277
Practice Address - Fax:561-630-6062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPENDING261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU7642Medicare PIN