Healthcare Provider Details

I. General information

NPI: 1144562612
Provider Name (Legal Business Name): JL X RAY OPTIONS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2013
Last Update Date: 03/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10340 NW 36TH CT
MIAMI FL
33147-1036
US

IV. Provider business mailing address

10340 NW 36TH CT
MIAMI FL
33147-1036
US

V. Phone/Fax

Practice location:
  • Phone: 305-884-2986
  • Fax: 866-653-0317
Mailing address:
  • Phone: 305-884-2986
  • Fax: 866-653-0317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0208X
TaxonomyMobile Radiology Clinic/Center
License NumberHCC9938
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code261QR0401X
TaxonomyComprehensive Outpatient Rehabilitation Facility (CORF)
License NumberHCC9938
License Number StateFL

VIII. Authorized Official

Name: LISANDRA BORGES
Title or Position: OWNER
Credential: LMT-BMO
Phone: 305-884-2986