Healthcare Provider Details

I. General information

NPI: 1184640633
Provider Name (Legal Business Name): MIAMI MEDICAL IMAGING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 03/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15387 SW 15TH LN
MIAMI FL
33194-2671
US

IV. Provider business mailing address

PO BOX 660127
MIAMI SPRINGS FL
33266-0127
US

V. Phone/Fax

Practice location:
  • Phone: 305-554-9599
  • Fax: 305-554-9599
Mailing address:
  • Phone: 305-554-9599
  • Fax: 305-554-9599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246XS1301X
TaxonomySonography Specialist/Technologist Cardiovascular
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2471S1302X
TaxonomySonography Radiologic Technologist
License Number
License Number State

VIII. Authorized Official

Name: MRS. DANAY PUEBLA LLANOS
Title or Position: PRESIDENT / OWNER
Credential: LMT
Phone: 305-554-9599