Healthcare Provider Details

I. General information

NPI: 1689622383
Provider Name (Legal Business Name): M & R DIAGNOSTIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 02/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8150 SW 8TH ST SUITE # 116
MIAMI FL
33144-4263
US

IV. Provider business mailing address

8150 SW 8TH ST SUITE # 116
MIAMI FL
33144-4263
US

V. Phone/Fax

Practice location:
  • Phone: 305-264-4096
  • Fax:
Mailing address:
  • Phone: 305-264-4096
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0208X
TaxonomyMobile Radiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MANUEL A DIAZ
Title or Position: PRESIDENT
Credential:
Phone: 305-264-4096