Provider Demographics
NPI:1750316527
Name:DPI OF NORTH BROWARD LLC
Entity type:Organization
Organization Name:DPI OF NORTH BROWARD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:STEPHAN
Authorized Official - Last Name:DEKKERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-566-4551
Mailing Address - Street 1:PO BOX 5047
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33310-5047
Mailing Address - Country:US
Mailing Address - Phone:954-566-4551
Mailing Address - Fax:954-566-4565
Practice Address - Street 1:6808 N STATE ROAD 7
Practice Address - Street 2:
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33073-4304
Practice Address - Country:US
Practice Address - Phone:954-566-4551
Practice Address - Fax:954-566-4565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology