Provider Demographics
NPI:1982884409
Name:BIOSCAN, INC.
Entity Type:Organization
Organization Name:BIOSCAN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A
Authorized Official - Last Name:BRUNS
Authorized Official - Suffix:
Authorized Official - Credentials:ARDMS
Authorized Official - Phone:954-471-8322
Mailing Address - Street 1:17627 123RD TERRACE N
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33478-4677
Mailing Address - Country:US
Mailing Address - Phone:954-471-8322
Mailing Address - Fax:561-972-7320
Practice Address - Street 1:17627 123RD TERRACE N
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33478-4677
Practice Address - Country:US
Practice Address - Phone:954-471-8322
Practice Address - Fax:561-972-7320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-13
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261QR0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE1990Medicare PIN
FLE1990Medicare UPIN