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General NPI Number Information
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NPI Number | 1477503043
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Entity Type | Organization
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Legal Business Name | B & G DIAGNOSTIC SERVICES INC
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 08/29/2012
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Provider Practice Location Address
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Address Line | 444 WEST 51 PLACE
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City | HIALEAH
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State | FL
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Zip | 33012
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Country | US
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Telephone | 305-818-2006
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Fax | 305-818-2009
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Provider Business Mailing Address
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Address Line | 444 WEST 51 PLACE
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City | HIALEAH
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State | FL
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Zip | 33012
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Country | US
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Telephone | 305-818-2006
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Fax | 305-818-2009
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Authorized Official
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Title or Position | PRESIDENT
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Name | BASILIO VALLE
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Credential |
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Telephone | 305-818-2006
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | HCC4095
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License Number State | FL
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