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General NPI Number Information
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NPI Number | 1144219874
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Entity Type | Organization
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Legal Business Name | SANTANA DIAGNOSTIC SERVICES CORP
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Dates
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Enumeration Date | 10/15/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 12855 SW 136TH AVE SUITE 212
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City | MIAMI
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State | FL
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Zip | 33186-5885
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Country | US
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Telephone | 305-251-4449
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Fax |
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Provider Business Mailing Address
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Address Line | 12855 SW 136TH AVE SUITE 212
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City | MIAMI
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State | FL
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Zip | 33186-5885
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Country | US
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Telephone | 305-251-4449
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MANUEL R DEL VALLE
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Credential |
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Telephone | 305-251-4449
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246XS1301X
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Taxonomy Name | Sonography Specialist/Technologist Cardiovascular
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License Number |
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License Number State |
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