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General NPI Number Information
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NPI Number | 1609501543
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Entity Type | Organization
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Legal Business Name | MIAMI SONOGRAM LLC
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Dates
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Enumeration Date | 07/22/2022
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Last Update Date | 07/22/2022
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Provider Practice Location Address
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Address Line | 8334 BIRD RD
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City | MIAMI
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State | FL
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Zip | 33155-3337
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Country | US
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Telephone | 786-988-2538
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Fax |
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Provider Business Mailing Address
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Address Line | 9595 FONTAINEBLEAU BLVD APT 2005
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City | MIAMI
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State | FL
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Zip | 33172-6890
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Country | US
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Telephone | 305-846-1972
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ISAC RAFAEL CABRERA DIAZ
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Credential |
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Telephone | 305-846-1972
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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