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General NPI Number Information
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NPI Number | 1205075702
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Entity Type | Organization
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Legal Business Name | MEDICAL DIAGNOSTICS INTERNATIONAL
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Dates
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Enumeration Date | 02/07/2009
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Last Update Date | 02/07/2009
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Provider Practice Location Address
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Address Line | 13500 SW 88TH ST
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City | MIAMI
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State | FL
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Zip | 33186-1515
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Country | US
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Telephone | 786-624-0014
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Fax | 786-507-7770
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Provider Business Mailing Address
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Address Line | 13500 SW 88TH ST
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City | MIAMI
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State | FL
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Zip | 33186-1515
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Country | US
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Telephone | 786-624-0014
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Fax | 786-507-7770
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | LUIS FELIPE HERNANDEZ
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Credential | D.O.
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Telephone | 786-586-5062
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 293D00000X
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Taxonomy Name | Physiological Laboratory
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License Number | G09002900058
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License Number State | FL
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