Healthcare Provider Details

I. General information

NPI: 1043246911
Provider Name (Legal Business Name): QUALITY DIAGNOSTIC & MEDICAL CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 SOUTH STATE ROAD 7
PLANTATION FL
33317
US

IV. Provider business mailing address

1567 SE 20 ROAD
HOMESTEAD LA
33035
US

V. Phone/Fax

Practice location:
  • Phone: 954-792-7113
  • Fax:
Mailing address:
  • Phone: 305-230-6620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number StateFL

VIII. Authorized Official

Name: MISS JESSICA MENENDEZ
Title or Position: OWNER
Credential: OWNER
Phone: 954-792-7113