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General NPI Number Information
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NPI Number | 1619849726
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Entity Type | Organization
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Legal Business Name | SOUTH MIAMI DIAGNOSTIC CENTER LLC
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Dates
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Enumeration Date | 09/18/2025
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 7000 SW 62ND AVE STE 100B
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-4717
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Country | US
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Telephone | 786-542-9844
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Fax |
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Provider Business Mailing Address
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Address Line | 7000 SW 62ND AVE STE 100B
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-4717
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Country | US
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Telephone | 786-542-9844
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | MONICA ALFONZO
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Credential |
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Telephone | 305-300-1093
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2471C3401X
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Taxonomy Name | Computed Tomography Radiologic Technologist
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License Number |
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License Number State |
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Taxonomy #2
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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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