Healthcare Provider Details

I. General information

NPI: 1134476385
Provider Name (Legal Business Name): MRI EXPRESS CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2012
Last Update Date: 08/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4567 NW 7TH ST
MIAMI FL
33126-2306
US

IV. Provider business mailing address

6095 NW 72ND AVE
MIAMI FL
33166-3737
US

V. Phone/Fax

Practice location:
  • Phone: 305-447-4461
  • Fax: 305-447-4460
Mailing address:
  • Phone: 786-414-3222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State

VIII. Authorized Official

Name: JOSE GUILLERMO ALVAREZ
Title or Position: PRESIDENT
Credential: M.D
Phone: 786-414-3222