OAKRIDGE MEDICAL GROUP; NPI #1912051228

Contact Information

OAKRIDGE MEDICAL GROUP

1000 NE 56TH ST
ATTN BUSINESS OFFICE
FORT LAUDERDALE, FL 33334-4149

Phone: 954-958-0606
Fax: 954-776-0821
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Radiologic Technologist	247100000X

Indicates primary specialty

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NPI Profile & details for OAKRIDGE MEDICAL GROUP

NPI Number 1912051228

LBN Legal business name OAKRIDGE MEDICAL GROUP

Authorized official FRITZ PHANORD - (BUSINESS OFFICE MANAGER)

Entity Organization

Organization subpart ¹ No

Enumeration date 01/23/2007

Last updated 08/22/2020 - About 6 years ago

Identifiers

FL	License #	JR3583900
FL	Other	7726045	AETNA PROVIDER ID
FL	Other	214355	AMERIGROUP PROVIDER ID
FL	Other	280077	AVMED PROVIDER ID
FL	Other	V2224	BC BS PROVIDER ID
FL	Other	221601	FDA#
FL	Other	498	TOTAL HLTH CHOICE ID
FL	Other	00002536540 02	UNITED HLTHCR ID
FL	Other	SG067359	VISTA HLTHCR ID

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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OAKRIDGE MEDICAL GROUP

Contact Information

Specialty

Radiologic Technologist

NPI Profile & details for OAKRIDGE MEDICAL GROUP

Reviews for OAKRIDGE MEDICAL GROUP