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General NPI Number Information
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NPI Number | 1073559928
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Entity Type | Organization
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Legal Business Name | L & G PROFESSIONAL SERVICES, INC
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Dates
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Enumeration Date | 06/21/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 14596 SW 95TH LN
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City | MIAMI
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State | FL
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Zip | 33186-1038
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Country | US
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Telephone | 305-216-2811
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Fax | 305-386-7826
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Provider Business Mailing Address
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Address Line | 14596 SW 95TH LN
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City | MIAMI
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State | FL
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Zip | 33186-1038
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Country | US
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Telephone | 305-216-2811
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Fax | 305-386-7826
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. GIOVANNI MENA
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Credential |
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Telephone | 305-216-2811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number | HCC6200
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License Number State | FL
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