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General NPI Number Information
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NPI Number | 1164489852
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Entity Type | Organization
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Legal Business Name | ADVANCED IMAGING SERVICES,INC.
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Dates
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Enumeration Date | 04/27/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 475 BILTMORE WAY
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City | CORAL GABLES
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State | FL
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Zip | 33134-5755
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Country | US
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Telephone | 305-442-2029
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Fax |
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Provider Business Mailing Address
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Address Line | 475 BILTMORE WAY #200
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City | CORAL GABLES
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State | FL
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Zip | 33134-5755
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Country | US
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Telephone | 305-442-2029
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | GRISEL CARVAJAL
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Credential | RDMS,RDCS,RVT
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Telephone | 305-318-4571
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | HCC5695
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License Number State | FL
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