| Atlantic Coast Radiology, Sf | |
|
220 Sw 84th Ave Ste 106 Plantation FL 33324-2729 | |
| (954) 452-0774 | |
| Not Available |
| Full Name | Atlantic Coast Radiology, Sf |
|---|---|
| Speciality | Clinic/Center |
| Location | 220 Sw 84th Ave Ste 106, Plantation, Florida |
| Authorized Official Name and Position | Ivan Ayala (PRESIDENT) |
| Authorized Official Contact | 9543182090 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Atlantic Coast Radiology, Sf 220 Sw 84th Ave Ste 106 Plantation FL 33324-2729 Ph: (954) 452-0774 | Atlantic Coast Radiology, Sf 220 Sw 84th Ave Ste 106 Plantation FL 33324-2729 Ph: (954) 452-0774 |
| NPI Number | 1972740462 |
|---|---|
| Provider Enumeration Date | 01/21/2009 |
| Last Update Date | 04/28/2021 |
| Medicare PECOS PAC ID | 9931257219 |
|---|---|
| Medicare Enrollment ID | O20090424000020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972740462 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Ivan L Ayala |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1497830897 PECOS PAC ID: 6608869417 Enrollment ID: I20040407000351 |
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