Provider Demographics
NPI:1174989255
Name:INDEPENDENT IMAGING LLC
Entity type:Organization
Organization Name:INDEPENDENT IMAGING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:
Authorized Official - Last Name:HANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:561-766-1300
Mailing Address - Street 1:PO BOX 1313
Mailing Address - Street 2:
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-1313
Mailing Address - Country:US
Mailing Address - Phone:561-766-1300
Mailing Address - Fax:561-693-0539
Practice Address - Street 1:11551 SOUTHERN BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-4254
Practice Address - Country:US
Practice Address - Phone:561-766-1300
Practice Address - Fax:561-693-0539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-05
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology