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General NPI Number Information
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NPI Number | 1427371095
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Entity Type | Organization
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Legal Business Name | DIMENSIONAL DIAGNOSTIC IMAGING OF MIAMI LLC
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Dates
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Enumeration Date | 03/10/2010
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Last Update Date | 03/10/2010
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Provider Practice Location Address
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Address Line | 664 E 25TH ST SUITE 103
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City | HIALEAH
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State | FL
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Zip | 33013-3805
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Country | US
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Telephone | 305-608-5549
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Fax | 305-553-6825
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Provider Business Mailing Address
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Address Line | 1740 SW 93RD CT
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City | MIAMI
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State | FL
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Zip | 33165-7739
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Country | US
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Telephone | 305-608-5549
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Fax | 305-553-6825
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Authorized Official
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Title or Position | OWNER
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Name | MRS. RAQUEL ALI
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Credential |
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Telephone | 305-608-5549
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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