Provider Demographics
NPI:1861028854
Name:NEXUS DIAGNOSTICS
Entity Type:Organization
Organization Name:NEXUS DIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TRENT
Authorized Official - Middle Name:
Authorized Official - Last Name:BROERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-849-4648
Mailing Address - Street 1:915 CLINT MOORE RD
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-2802
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:915 CLINT MOORE RD
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-2802
Practice Address - Country:US
Practice Address - Phone:954-849-4648
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-21
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0500XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherEEGGroup - Multi-Specialty
No204R00000XAllopathic & Osteopathic PhysiciansElectrodiagnostic MedicineGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile
No293D00000XLaboratoriesPhysiological LaboratoryGroup - Multi-Specialty
No335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging SupplierGroup - Multi-Specialty