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General NPI Number Information
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NPI Number | 1164608006
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Entity Type | Organization
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Legal Business Name | PRECISION IMAGING & DIAGNOSTIC CENTER INC
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Dates
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Enumeration Date | 01/10/2008
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Last Update Date | 01/10/2008
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Provider Practice Location Address
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Address Line | 1710 SW 27TH AVE SUITE 201
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City | MIAMI
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State | FL
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Zip | 33145-2451
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Country | US
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Telephone | 305-447-2324
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Fax | 305-447-2358
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Provider Business Mailing Address
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Address Line | 1710 SW 27TH AVE SUITE 201
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City | MIAMI
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State | FL
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Zip | 33145-2451
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Country | US
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Telephone | 305-447-2324
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Fax | 305-447-2358
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Authorized Official
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Title or Position | PRESIDENT
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Name | PAVEL GONZALEZ
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Credential |
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Telephone | 305-447-2324
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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 | HCC 7961
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License Number State | FL
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