Healthcare Provider Details

I. General information

NPI: 1508899659
Provider Name (Legal Business Name): ALFA DIAGNOSTIC MOBILE SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8370 W FLAGLER ST STE 246
MIAMI FL
33144-2094
US

IV. Provider business mailing address

8370 W FLAGLER ST STE 246
MIAMI FL
33144-2094
US

V. Phone/Fax

Practice location:
  • Phone: 305-554-1737
  • Fax: 305-554-1737
Mailing address:
  • Phone: 305-554-1737
  • Fax: 305-554-1737

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberHCC5587
License Number StateFL

VIII. Authorized Official

Name: HECTOR PALACIOS
Title or Position: DIRECTOR/OFFICER
Credential:
Phone: 305-554-1737