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NPI Code Detail

MEDICARE: CORAL GABLES MRI INC

MEDICARE: CORAL GABLES MRI INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QS1200XSleep Disorder Diagnostic Clinic/Center
2261QM1200XMagnetic Resonance Imaging (MRI) Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1336236363
Entity Type Code : Organization
Provider Name (Legal Business Name) : CORAL GABLES MRI INC
Provider Business Mailing Address
First Line : 780 NW 42ND AVE STE 301
Second Line :
City : MIAMI
State : FL
Zip : 33126-5536
Country : US
Telephone Number : 305-446-7893
Fax Number : 305-442-1183
Provider Business Practice Location Address
First Line : 747 PONCE DE LEON BLVD
Second Line :
City : CORAL GABLES
State : FL
Zip : 33134-2049
Country : US
Telephone Number : 305-446-7893
Fax Number : 305-442-1183
Authorized Official
Title or Position : PRESIDENT
Name : MS. ELIZABETH BRACERAS
Credential :
Telephone Number : 305-863-8860
Provider Enumeration Date : 10/10/2006
Last Update Date : 03/02/2026

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