Healthcare Provider Details

I. General information

NPI: 1629185541
Provider Name (Legal Business Name): DIAGNOSTIC CENTER FOR WOMEN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 09/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7500 SW 87TH AVE SUITE 100
MIAMI FL
33173-5426
US

IV. Provider business mailing address

7500 SW 87TH AVE SUITE 100
MIAMI FL
33173-5426
US

V. Phone/Fax

Practice location:
  • Phone: 305-740-5100
  • Fax: 305-740-5101
Mailing address:
  • Phone: 305-740-5100
  • Fax: 305-740-5101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0206X
TaxonomyMammography Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PATRICIA C VARONA
Title or Position: DIRECTOR
Credential:
Phone: 305-740-5100