Healthcare Provider Details

I. General information

NPI: 1104368471
Provider Name (Legal Business Name): QUALITY DIAGNOSTIC HEALTH CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2016
Last Update Date: 11/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3383 NW 7TH ST SUITE 109A
MIAMI FL
33125-4140
US

IV. Provider business mailing address

3383 NW 7TH ST SUITE 109A
MIAMI FL
33125-4140
US

V. Phone/Fax

Practice location:
  • Phone: 305-642-8718
  • Fax: 305-642-8792
Mailing address:
  • Phone: 305-642-8718
  • Fax: 305-642-8792

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. JORGE MARTINEZ
Title or Position: OWNER
Credential:
Phone: 305-642-8718