=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154651107
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DIAGNOSTIC & RADIOLOGY OF MIAMI INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/13/2010
-----------------------------------------------------
Last Update Date | 09/24/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2500 NW 79TH AVE STE 102
-----------------------------------------------------
City | DORAL
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33122-1071
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-871-4777
-----------------------------------------------------
Fax | 305-871-4333
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2500 NW 79TH AVE STE 102
-----------------------------------------------------
City | DORAL
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33122-1071
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-871-4777
-----------------------------------------------------
Fax | 305-871-4333
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | ONEIDA SANTANA .
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 305-871-4777
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208D00000X
-----------------------------------------------------
Taxonomy Name | General Practice Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------