Healthcare Provider Details
I. General information
NPI: 1699077313
Provider Name (Legal Business Name): PINNACLE INTERVENTIONAL CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/01/2010
Last Update Date: 12/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2380 NW 7TH ST
MIAMI FL
33125-3249
US
IV. Provider business mailing address
2390 NW 7TH ST
MIAMI FL
33125-3226
US
V. Phone/Fax
- Phone: 786-219-1402
- Fax: 786-219-1404
- Phone: 786-219-1402
- Fax: 786-219-1404
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2471C3402X |
| Taxonomy | Radiography Radiologic Technologist |
| License Number | |
| License Number State | FL |
VIII. Authorized Official
Name: MR.
ALI
H
JAAFAR
Title or Position: CEO
Credential:
Phone: 305-642-7388