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General NPI Number Information
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NPI Number | 1023028198
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Entity Type | Organization
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Legal Business Name | KENDALL OPEN MRI, LLC
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 05/21/2012
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Provider Practice Location Address
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Address Line | 9280 SUNSET DRIVE SUITE 101
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City | MIAMI
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State | FL
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Zip | 33173
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Country | US
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Telephone | 305-596-6242
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Fax | 305-596-6992
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Provider Business Mailing Address
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Address Line | 9280 SUNSET DRIVE SUITE 101
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City | MIAMI
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State | FL
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Zip | 33173
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Country | US
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Telephone | 305-596-6242
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Fax | 305-596-6992
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Authorized Official
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Title or Position | OWNER
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Name | MR. YODIOSMAY GONZALEZ
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Credential |
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Telephone | 305-596-6242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | HCC2438
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License Number State | FL
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