Healthcare Provider Details
I. General information
NPI: 1992001424
Provider Name (Legal Business Name): TOTAL DIAGNOSTIC SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/01/2011
Last Update Date: 03/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
297 SW 27TH AVE
MIAMI FL
33135-1401
US
IV. Provider business mailing address
297 SW 27TH AVE
MIAMI FL
33135-1401
US
V. Phone/Fax
- Phone: 305-960-7050
- Fax: 305-960-7184
- Phone: 305-960-7050
- Fax: 305-960-7184
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085B0100X |
| Taxonomy | Body Imaging Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CARLOS
GARCIA
Title or Position: MGRM
Credential:
Phone: 305-960-7050