Provider Demographics
NPI:1841394178
Name:SWALLOWING DIAGNOSTICS, INC.
Entity Type:Organization
Organization Name:SWALLOWING DIAGNOSTICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STACY
Authorized Official - Middle Name:
Authorized Official - Last Name:TARAKOFSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-578-4000
Mailing Address - Street 1:11085 NW 15TH ST
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-6488
Mailing Address - Country:US
Mailing Address - Phone:954-578-4000
Mailing Address - Fax:954-578-4948
Practice Address - Street 1:4486 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33351-4513
Practice Address - Country:US
Practice Address - Phone:954-578-4000
Practice Address - Fax:954-578-4948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-08
Last Update Date:2009-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile