Healthcare Provider Details

I. General information

NPI: 1689677668
Provider Name (Legal Business Name): CENTER FOR DIAGNOSTIC IMAGING LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 01/17/2025
Certification Date: 01/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1380 NE MIAMI GARDENS DR STE 115
NORTH MIAMI BEACH FL
33179-4708
US

IV. Provider business mailing address

1380 NE MIAMI GARDENS DR STE 115
NORTH MIAMI BEACH FL
33179-4708
US

V. Phone/Fax

Practice location:
  • Phone: 305-947-4461
  • Fax: 305-947-4940
Mailing address:
  • Phone: 305-947-4461
  • Fax: 305-947-4940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number2755834
License Number StateFL

VIII. Authorized Official

Name: MR. JOSEPH OKSEMBERG
Title or Position: OFFICE MANAGER
Credential:
Phone: 305-947-4461