Healthcare Provider Details

I. General information

NPI: 1710967948
Provider Name (Legal Business Name): SOUND DIAGNOSTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 RODEO LN SUITE B3
SANTA FE NM
87507-4890
US

IV. Provider business mailing address

3600 RODEO LN SUITE B3
SANTA FE NM
87507-4890
US

V. Phone/Fax

Practice location:
  • Phone: 505-438-2828
  • Fax: 505-473-3196
Mailing address:
  • Phone: 505-438-2828
  • Fax: 505-473-3196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2471S1302X
TaxonomySonography Radiologic Technologist
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN EVERETT MILES
Title or Position: MANAGING MEMBER
Credential:
Phone: 505-983-5653