Healthcare Provider Details

I. General information

NPI: 1568404796
Provider Name (Legal Business Name): PRESTIGE DIAGNOSTIC CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6447 MIAMI LAKES DR SUITE 210C
MIAMI LAKES FL
33014-2760
US

IV. Provider business mailing address

6447 MIAMI LAKES DR SUITE 210C
MIAMI LAKES FL
33014-2760
US

V. Phone/Fax

Practice location:
  • Phone: 786-639-0505
  • Fax: 786-639-0555
Mailing address:
  • Phone: 786-639-0505
  • Fax: 786-639-0555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2278P1004X
TaxonomyPulmonary Diagnostics Certified Respiratory Therapist
License Number
License Number State

VIII. Authorized Official

Name: SARAH LOO FIGUEREDO
Title or Position: PRESIDENT
Credential:
Phone: 786-639-0505