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General NPI Number Information
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NPI Number | 1649778721
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Entity Type | Organization
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Legal Business Name | INTERSCAN INC
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Dates
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Enumeration Date | 01/24/2018
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Last Update Date | 01/24/2018
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Provider Practice Location Address
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Address Line | 1444 W 49TH ST
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City | HIALEAH
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State | FL
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Zip | 33012-3219
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Country | US
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Telephone | 305-821-8949
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Fax | 305-821-1964
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Provider Business Mailing Address
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Address Line | 1444 W 49TH ST
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City | HIALEAH
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State | FL
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Zip | 33012-3219
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Country | US
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Telephone | 305-821-8949
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Fax | 305-821-1964
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Authorized Official
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Title or Position | OWNER
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Name | YIGANI RODRIGUEZ
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Credential |
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Telephone | 305-821-8949
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | HCC9892
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License Number State | FL
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