Organization · Type 2 NPI

Professional Portable Radiologic Services Inc.

Physiological Laboratory · Ormond Beach, FL

NPI number 1174228308 Active

Practice location

1400 Hand Ave Ste A
Ormond Beach, FL 32174-8195

Call (303) 500-1518 Map

Mailing address

3825 N Lafayette St
Denver, CO 80205-3316

Specialties and licenses

Taxonomy	Code	License
Physiological Laboratory Primary	293D00000X	None listed

Physiological Laboratory: A laboratory that operates independently of a hospital and physician's office to furnish physiological diagnostic services (e.g. EEG's , EKG's, scans, etc.). Facilities offering ONLY physiological services are not certified as independent laboratories. If an independent laboratory offers physiological services IN ADDITION to clinical laboratory services, they are surveyed only for compliance with the clinical labora…

3 other providers at this address

NPI record

NPI: 1174228308
Entity type: Organization (Type 2)
Issued: Apr 5, 2023
Last updated: Jul 7, 2025
Status: Active

Other names

<unavail>
Dynamic Mobile Imaging · doing business as
Dynamic Mobile Imaging · doing business as

Authorized official

William Kramer
Chief Legal Officer
(215) 813-5940

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1174228308

Professional Portable Radiologic Services Inc.'s National Provider Identifier is 1174228308, issued on Apr 5, 2023. The primary taxonomy on file is Physiological Laboratory (293D00000X), and the practice location is in Ormond Beach, FL. The record was last updated on Jul 7, 2025.