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General NPI Number Information
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NPI Number | 1568404796
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Entity Type | Organization
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Legal Business Name | PRESTIGE DIAGNOSTIC CORP
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Dates
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Enumeration Date | 06/12/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6447 MIAMI LAKES DR SUITE 210C
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City | MIAMI LAKES
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State | FL
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Zip | 33014-2760
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Country | US
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Telephone | 786-639-0505
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Fax | 786-639-0555
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Provider Business Mailing Address
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Address Line | 6447 MIAMI LAKES DR SUITE 210C
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City | MIAMI LAKES
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State | FL
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Zip | 33014-2760
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Country | US
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Telephone | 786-639-0505
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Fax | 786-639-0555
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Authorized Official
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Title or Position | PRESIDENT
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Name | SARAH LOO FIGUEREDO
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Credential |
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Telephone | 786-639-0505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2278P1004X
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Taxonomy Name | Pulmonary Diagnostics Certified Respiratory Therapist
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License Number |
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License Number State |
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