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General NPI Number Information
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NPI Number | 1588263941
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Entity Type | Organization
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Legal Business Name | PRO RAD IMAGING SERVICES, LLC
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Dates
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Enumeration Date | 10/18/2020
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Last Update Date | 10/18/2020
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Provider Practice Location Address
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Address Line | 81 N HIBISCUS DR
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City | MIAMI BEACH
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State | FL
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Zip | 33139-5117
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Country | US
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Telephone | 786-553-4510
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Fax |
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Provider Business Mailing Address
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Address Line | 81 N HIBISCUS DR
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City | MIAMI BEACH
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State | FL
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Zip | 33139-5117
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Country | US
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Telephone | 786-553-4510
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GERMAINE RODRIGUEZ
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Credential | MD
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Telephone | 756-553-4510
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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 |
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License Number State |
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