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General NPI Number Information
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NPI Number | 1154548741
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Entity Type | Organization
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Legal Business Name | JMV DIAGNOSTIC
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 15422 SW 115TH ST
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City | MIAMI
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State | FL
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Zip | 33196-6310
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Country | US
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Telephone | 305-992-8857
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Fax | 305-383-1593
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Provider Business Mailing Address
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Address Line | 8890 SW 24TH ST SUITE 208
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City | MIAMI
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State | FL
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Zip | 33165-2060
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Country | US
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Telephone | 305-992-8857
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Fax | 305-383-1593
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAIRO IVAN MENESES
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Credential |
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Telephone | 305-992-8857
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2471S1302X
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Taxonomy Name | Sonography Radiologic Technologist
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License Number | 545566-2
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License Number State | FL
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