SOUTHEASTERN IMAGING, INC (NPI# 1669996195) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669996195 |
| Entity Type | Organization |
| Organization Name | SOUTHEASTERN IMAGING, INC |
| Practice Address |
100 S Birch Rd Apt 1001 Fort Lauderdale FL 33316-1542 |
| Mailing Address |
100 S Birch Rd, Ste 1001 Fort Lauderdale FL 33316 |
| Practice Telephone | 9543433293 |
| Enumeration Date | 2017-07-26 |
| Last Update Date | 2017-07-26 |
| Authorized Official Name | TEA KAGANOVICH (PRESIDENT) |
| Authorized Official Telephone | 9543433293 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| Street Address |
100 S BIRCH RD APT 1001 |
| City | FORT LAUDERDALE |
| State | FL |
| Zip Code | 33316-1542 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366064040 | Jonathan David Ortiz | Behavior Technician | 1717 Se 4 Ave, Fort Lauderdale, FL 33316 | 2020-05-15 |
| 1306311626 | Gateway Recovery Center, LLC | Counselor | 1421 Sw 4th Avenue, Suite B, Fort Lauderdale, FL 33316 | 2018-10-13 |
| 1588141626 | Natan Bastoky | Family Medicine | 1600 S Andrews Ave # Gme, Fort Lauderdale, FL 33316 | 2018-07-22 |
| 1104320126 | Kathleen Kanani Graham | Pharmacist | 1401 S. Federal Highway, Ft. Lauderdale, FL 33316 | 2018-03-23 |
| 1093224271 | Lacosta Therapy, LLC | Behavioral Analyst | 412 Se 15 St., #4, Ft. Lauderdale, FL 33316 | 2017-09-20 |
| 1124560370 | Yulia Rybalka | Pharmacist | 217 Se 10th Street, Ft Lauderdale, FL 33316 | 2016-11-04 |
| 1730635376 | Brian Alexander Reyes | Specialist/Technologist | 303 Se 3rd Ave, Ft Lauderdale, FL 33316 | 2016-09-01 |
| 1649726282 | Jennifer Tabares | Specialist/Technologist | 303 Southeast 3rd Av, Fort Lauderdale, FL 33316 | 2016-09-01 |
| 1609236850 | Diane Nicole Shilling | Nurse Practitioner | 1001 South Andrews Avenue, Suite 100, Ft. Lauderdale, FL 33316 | 2016-03-01 |
| 1396113239 | Victoria Rosado | Adult Companion | 150 Se 12th Street, 401(b), Fort Lauderdale, FL 33316 | 2015-09-09 |
| Find all providers in zip 33316 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386161313 | Bentley Sunrise Pa | Specialist | 715 Bayshore Dr Apt 406, Fort Lauderdale, FL 33304-3990 | 2017-08-30 |
| 1124564281 | Alloy Behavioral Health Solutions, Inc | Specialist | 1835 S Perimeter Road Suite 170, Fort Lauderdale, FL 33309 | 2017-01-13 |
| 1568852101 | Y Line LLC | Specialist | 3325 Griffin Rd Ste 185, Fort Lauderdale, FL 33312-5500 | 2015-02-04 |
| 1477997013 | Usa Wellness Providers Corp | Specialist | 1050 Lee Wagener Blvd, 230, Fort Lauderdale, FL 33315-3500 | 2013-04-25 |
| 1346582087 | Linda Lee Civerchia | Specialist | 333 Las Olas Way 210, Fort Lauderdale, FL 33301-2363 | 2013-03-20 |
| 1568711588 | Carlos Vargas | Specialist | 1400 Ne 18th St Apt 1, Fort Lauderdale, FL 33305-3341 | 2012-09-05 |
| 1124319108 | Francisco Belette Md Pa | Specialist | 6505 N Federal Hwy, Suite 300b, Fort Lauderdale, FL 33308 | 2011-04-26 |
| 1538479746 | Curtis B.schwartz,md.pa | Specialist | 1777 S.andrews Avenue, Suite300, Fort Lauderdale, FL 33316 | 2010-10-21 |
| 1881914232 | Crystal Fennessy | Specialist | 3045 N Federal Hwy Ste 60h, Fort Lauderdale, FL 33306-1415 | 2010-06-08 |
| 1578791547 | Pauline L Haughton | Specialist | 1170 Indiana Ave, Fort Lauderdale, FL 33312-7307 | 2009-06-29 |
| Find all providers in FORT LAUDERDALE | ||||
| City | FORT LAUDERDALE |
| Zip Code | 33316 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.