Provider Demographics
NPI:1912967654
Name:RADIOLOGIC HEATHCARE SERVICES
Entity Type:Organization
Organization Name:RADIOLOGIC HEATHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:HANCOCK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-332-6151
Mailing Address - Street 1:1508 BAY RD
Mailing Address - Street 2:APT. 31
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-3229
Mailing Address - Country:US
Mailing Address - Phone:305-332-6151
Mailing Address - Fax:305-673-5847
Practice Address - Street 1:1508 BAY RD
Practice Address - Street 2:APT. 31
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33139-3229
Practice Address - Country:US
Practice Address - Phone:305-332-6151
Practice Address - Fax:305-673-5847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL000268132471B0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471B0102XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistBone DensitometryGroup - Single Specialty