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General NPI Number Information
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NPI Number | 1477168714
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Entity Type | Organization
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Legal Business Name | INDAGO IMAGING
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Dates
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Enumeration Date | 09/14/2020
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Last Update Date | 09/14/2020
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Provider Practice Location Address
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Address Line | 3716 W 12TH AVE
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City | HIALEAH
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State | FL
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Zip | 33012-4126
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Country | US
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Telephone | 786-942-1057
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Fax |
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Provider Business Mailing Address
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Address Line | 3716 W 12TH AVE
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City | HIALEAH
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State | FL
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Zip | 33012-4126
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Country | US
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Telephone | 786-942-1057
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Fax |
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Authorized Official
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Title or Position | VP
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Name | LIANNE SUAREZ
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Credential |
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Telephone | 786-942-1057
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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