MEDICARE: SOUND DIAGNOSTICS LLC

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
1	2471S1302X	Sonography Radiologic Technologist

General Provider Information

NPI Number	:	1710967948
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUND DIAGNOSTICS LLC

Provider Business Mailing Address
First Line	:	3600 RODEO LN
Second Line	:	SUITE B3
City	:	SANTA FE
State	:	NM
Zip	:	87507-4890
Country	:	US
Telephone Number	:	505-438-2828
Fax Number	:	505-473-3196

Provider Business Practice Location Address
First Line	:	3600 RODEO LN
Second Line	:	SUITE B3
City	:	SANTA FE
State	:	NM
Zip	:	87507-4890
Country	:	US
Telephone Number	:	505-438-2828
Fax Number	:	505-473-3196

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	MR. JOHN EVERETT MILES
Credential	:
Telephone Number	:	505-983-5653

Provider Enumeration Date	:	01/23/2006
Last Update Date	:	08/22/2020

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