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General NPI Number Information
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NPI Number | 1376852178
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Entity Type | Organization
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Legal Business Name | LAKES IMAGING SERVICES INC
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Dates
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Enumeration Date | 09/28/2010
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Last Update Date | 07/08/2011
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Provider Practice Location Address
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Address Line | 6001 NW 153RD ST STE 154
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City | MIAMI LAKES
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State | FL
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Zip | 33014-2447
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Country | US
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Telephone | 305-818-7473
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Fax | 305-328-9629
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Provider Business Mailing Address
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Address Line | 6001 NW 153RD ST STE 154
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City | MIAMI LAKES
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State | FL
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Zip | 33014-2447
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. ONSLAIDYS MACHIN
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Credential |
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Telephone | 786-333-1368
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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 |
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License Number State |
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