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General NPI Number Information
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NPI Number | 1639579972
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Entity Type | Organization
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Legal Business Name | ADVANCE MRI
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Dates
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Enumeration Date | 08/22/2014
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Last Update Date | 08/22/2014
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Provider Practice Location Address
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Address Line | 8900 SW 107TH AVE SUITE 110
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City | MIAMI
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State | FL
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Zip | 33176-1451
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Country | US
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Telephone | 305-271-0570
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Fax | 305-271-0520
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Provider Business Mailing Address
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Address Line | 8900 SW 107TH AVE SUITE 110
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City | MIAMI
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State | FL
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Zip | 33176-1451
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Country | US
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Telephone | 305-271-0570
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Fax |
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Authorized Official
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Title or Position | COMPANY PRESIDENT
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Name | DANIEL MARTINEZ
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Credential | SR
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Telephone | 305-471-4593
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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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