Children'S Diagnostic Testing Group Of Broward, INC.
Clinic/Center, Radiology in Hollywood, FL. Organization (NPI-2).
NPI number1487864310
StatusActive
Last updated in NPPESSep 11, 2025
Details
- NPI
- 1487864310
- Entity type
- Organization (NPI-2)
- Legal business name
- Children'S Diagnostic Testing Group Of Broward, INC.
- Organization subpart
- No
- Enumeration date
- May 22, 2007
- Last updated
- Sep 11, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QR0200X | Clinic/Center, Radiology | – | – | Yes |
| 261QM1200X | Clinic/Center, Magnetic Resonance Imaging (MRI) | – | – | |
| 261QM1300X | Clinic/Center, Multi-Specialty | – | – |
Practice location
11011 Sheridan StSuite 101
Hollywood, FL 33026-1505
Phone 305-275-6069 · Fax 305-412-8265
Mailing address
9485 Sw 72nd StSuite A150
Miami, FL 33173-3242
Phone 305-275-6069 · Fax 305-412-8265
Authorized official
Stephen E Cianciulli
President
3052756069
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