Provider Demographics
NPI:1528079894
Name:DIAGNOSTIC READERS GROUP INC
Entity type:Organization
Organization Name:DIAGNOSTIC READERS GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YALE
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMOLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-662-5219
Mailing Address - Street 1:PO BOX 864672
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32886-4672
Mailing Address - Country:US
Mailing Address - Phone:954-726-1808
Mailing Address - Fax:954-726-1820
Practice Address - Street 1:6200 SW 73RD ST
Practice Address - Street 2:- EKG READERS PANEL
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4679
Practice Address - Country:US
Practice Address - Phone:954-726-1808
Practice Address - Fax:954-726-1820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2014-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL97554OtherBCBS
FL97554OtherBCBS