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General NPI Number Information
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NPI Number | 1164829974
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Entity Type | Organization
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Legal Business Name | AAA THERAPY & IMAGING CENTER INC
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Dates
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Enumeration Date | 11/21/2014
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Last Update Date | 12/04/2014
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Provider Practice Location Address
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Address Line | 3900 NW 79TH AVE SUITE 582
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City | DORAL
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State | FL
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Zip | 33166-6556
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Country | US
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Telephone | 305-798-3075
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Fax | 305-503-7320
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Provider Business Mailing Address
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Address Line | 3900 NW 79TH AVE SUITE 582
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City | DORAL
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State | FL
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Zip | 33166-6556
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Country | US
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Telephone | 305-798-3075
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Fax | 305-503-7320
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | MARIA I DELGADO
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Credential | MD
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Telephone | 305-798-3075
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | ME65520
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License Number State | FL
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