Healthcare Provider Details
I. General information
NPI: 1205146966
Provider Name (Legal Business Name): RS RADIOLOGY, PL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/15/2010
Last Update Date: 06/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
90 ALTON ROAD PH 3310
MIAMI BEACH FL
33139
US
IV. Provider business mailing address
90 ALTON ROAD PH 3310
MIAMI BEACH FL
33139
US
V. Phone/Fax
- Phone: 786-553-4510
- Fax: 305-722-3625
- Phone: 786-553-4510
- Fax: 305-722-3625
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
GERMAINE
RODRIGUEZ
Title or Position: PRESIDENT
Credential: MD
Phone: 786-553-4510