Healthcare Provider Details

I. General information

NPI: 1710154190
Provider Name (Legal Business Name): A & C MOBILE DIAGNOSTIC SERVICES CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2008
Last Update Date: 05/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10550 NW 77TH CT SUITE# 313-314
HIALEAH GARDENS FL
33016-7084
US

IV. Provider business mailing address

10550 NW 77TH CT SUITE# 313-314
HIALEAH GARDENS FL
33016-7084
US

V. Phone/Fax

Practice location:
  • Phone: 305-827-8919
  • Fax: 305-827-8918
Mailing address:
  • Phone: 305-827-8919
  • Fax: 305-827-8918

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0208X
TaxonomyMobile Radiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: YUSIMI ALVAREZ
Title or Position: OWNER
Credential:
Phone: 305-827-8919