Healthcare Provider Details

I. General information

NPI: 1710142401
Provider Name (Legal Business Name): SAN REMO BREAST AND MRI CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2008
Last Update Date: 03/13/2023
Certification Date: 03/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1545 SAN REMO AVE
CORAL GABLES FL
33146-3008
US

IV. Provider business mailing address

15601 DALLAS PKWY STE 300
ADDISON TX
75001-6012
US

V. Phone/Fax

Practice location:
  • Phone: 305-403-4930
  • Fax: 305-403-4940
Mailing address:
  • Phone: 469-398-4167
  • Fax: 469-609-0283

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. CHIRAG PARGHI
Title or Position: OWNER
Credential: MD
Phone: 833-979-2086