Healthcare Provider Details

I. General information

NPI: 1538147269
Provider Name (Legal Business Name): MG NEUROVASCULAR ULTRASOUND SERV
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3383 NW 7TH ST SUITE 107/108
MIAMI FL
33125-4140
US

IV. Provider business mailing address

3383 NW 7TH ST SUITE 107/108
MIAMI FL
33125-4140
US

V. Phone/Fax

Practice location:
  • Phone: 305-644-1795
  • Fax:
Mailing address:
  • Phone: 305-644-1795
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2471S1302X
TaxonomySonography Radiologic Technologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number StateFL

VIII. Authorized Official

Name: MISS MARLIN DANILA MEJIA
Title or Position: PRESIDENT
Credential:
Phone: 305-644-1717