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NPI Code Detail

MEDICARE: IMAGEN DIAGNOSTIC SERVICES, INC.

MEDICARE: IMAGEN DIAGNOSTIC SERVICES, 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
12085U0001XDiagnostic Ultrasound Physician
2208D00000XGeneral Practice Physician

General Provider Information

NPI Number : 1619276508
Entity Type Code : Organization
Provider Name (Legal Business Name) : IMAGEN DIAGNOSTIC SERVICES, INC.
Provider Business Mailing Address
First Line : 3970 W FLAGLER ST
Second Line : SUITE 104
City : CORAL GABLES
State : FL
Zip : 33134-1642
Country : US
Telephone Number : 305-456-2160
Fax Number : 305-456-0628
Provider Business Practice Location Address
First Line : 3970 W FLAGLER ST
Second Line : SUITE 104
City : CORAL GABLES
State : FL
Zip : 33134-1642
Country : US
Telephone Number : 305-456-2160
Fax Number : 305-456-0628
Authorized Official
Title or Position : PRESIDENT
Name : AYME RUIZ
Credential :
Telephone Number : 305-456-2162
Provider Enumeration Date : 03/18/2011
Last Update Date : 03/18/2011

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Directions to “IMAGEN DIAGNOSTIC SERVICES, INC. ” Practice Location

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