Healthcare Provider Details

I. General information

NPI: 1073506325
Provider Name (Legal Business Name): CARDIOVASCULAR MOBILE SERVICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2005
Last Update Date: 09/02/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9200 SW 72ND ST BLDG 4
MIAMI FL
33173-3240
US

IV. Provider business mailing address

9200 SW 72ND ST BUILDING #4
MIAMI FL
33173-3240
US

V. Phone/Fax

Practice location:
  • Phone: 305-227-2500
  • Fax: 305-403-8740
Mailing address:
  • Phone: 305-227-2500
  • Fax: 305-220-7133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License NumberHCC5026
License Number StateFL

VIII. Authorized Official

Name: MR. ALEJANRO ENRIQUE XIQUES
Title or Position: CEO
Credential:
Phone: 305-227-2500