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General NPI Number Information
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NPI Number | 1306937214
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Entity Type | Organization
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Legal Business Name | AB DIAGNOSTIC CENTER
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 08/21/2007
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Provider Practice Location Address
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Address Line | 3803 NW 125 ST
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City | OPA LOCKA
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State | FL
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Zip | 33054
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Country | US
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Telephone | 305-687-8780
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Fax | 305-687-8896
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Provider Business Mailing Address
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Address Line | 3803 NW 125 ST
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City | OPA LOCKA
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State | FL
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Zip | 33054
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Country | US
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Telephone | 305-687-8780
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Fax | 305-687-8896
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Authorized Official
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Title or Position | OWNER
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Name | MR. LUIS ACOSTA
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Credential |
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Telephone | 305-687-8780
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
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License Number |
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License Number State |
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