Healthcare Provider Details

I. General information

NPI: 1588760573
Provider Name (Legal Business Name): M & G DIAGNOSTIC SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9535 SW 40TH ST
MIAMI FL
33165-4035
US

IV. Provider business mailing address

9535 SW 40TH ST
MIAMI FL
33165-4035
US

V. Phone/Fax

Practice location:
  • Phone: 305-270-8381
  • Fax: 305-220-7133
Mailing address:
  • Phone: 305-270-8381
  • Fax: 305-220-7133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246XS1301X
TaxonomySonography Specialist/Technologist Cardiovascular
License NumberHCC4367
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License NumberHCC4367
License Number StateFL

VIII. Authorized Official

Name: MRS. VIVIAN DIAZ
Title or Position: PRESIDENT
Credential:
Phone: 305-270-8381