PET Imaging Institute of South Florida – Radiology Clinic/Center, NPI 1124020656

PET Imaging Institute of South Florida is a healthcare provider. based in Hollywood, Florida. specializing in Radiology Clinic/Center. The organization holds a License No. HCC5507 (FL). The NPI Number for PET Imaging Institute of South Florida is 1124020656

Main info

Organization
Name
PET Imaging Institute of South Florida
NPI
1124020656
Phone
(954) 981-6668
Address
1150 N 35TH AVE
Authorized Official
LISETTE CRUZ-DENO MANAGING DIRECTOR
Enumeration Date
15 August 2005
Last Update Date
12 December 2013
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness80
Years active:20State licenses:1Digital endpointsUpdated within 12 months

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Provider Addresses for PET Imaging Institute of South Florida

  • 1150, North 35th Avenue, West Hollywood, Hollywood, Broward County, Florida, 33021, United States

    SUITE 665

    HOLLYWOOD, FL 330215424

    Phone: (954) 981-6668

    Fax: (954) 981-5944

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-10-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20251017000767OClinic/Group PracticeTXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33021)

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Reviews

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Frequently asked questions

What is the 10-digit NPI for PET Imaging Institute of South Florida?
PET Imaging Institute of South Florida — NPI 1124020656 — is the standard way to identify this listing.
Can I rely on PET Imaging Institute of South Florida being an active provider?
As of the registry snapshot, PET Imaging Institute of South Florida is marked active.
What is PET Imaging Institute of South Florida best known for clinically?
Directory data describes PET Imaging Institute of South Florida with Radiology Clinic/Center. Clinical services aligned with this taxonomy classification.
Does PET Imaging Institute of South Florida list a practice location?
Patients near Hollywood, Florida may find PET Imaging Institute of South Florida in results; validate coverage separately.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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