Healthcare Provider Details

I. General information

NPI: 1356542302
Provider Name (Legal Business Name): WEST HIALEAH IMAGING ASSOCIATES LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 12/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1475 W 49TH ST
HIALEAH FL
33012-3222
US

IV. Provider business mailing address

5901 SW 74TH ST SUITE 202
MIAMI FL
33143-5165
US

V. Phone/Fax

Practice location:
  • Phone: 305-666-2427
  • Fax: 305-667-0239
Mailing address:
  • Phone: 305-666-2427
  • Fax: 305-667-0239

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: LUIS O ALVAREZ
Title or Position: PRESIDENT
Credential: M.D.
Phone: 305-665-4614