Provider Demographics
NPI:1043720022
Name:PATIENT FIRST DIAGNOSTICS
Entity type:Organization
Organization Name:PATIENT FIRST DIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MARCO
Authorized Official - Middle Name:
Authorized Official - Last Name:MELO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-260-8339
Mailing Address - Street 1:575 NE 5TH TER APT 753
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33301-2170
Mailing Address - Country:US
Mailing Address - Phone:317-260-8339
Mailing Address - Fax:
Practice Address - Street 1:575 NE 5TH TER APT 753
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33301-2170
Practice Address - Country:US
Practice Address - Phone:317-260-8339
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-04
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile