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General NPI Number Information
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NPI Number | 1679528996
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Entity Type | Organization
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Legal Business Name | GA SONOGRAPHY,INC
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Dates
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Enumeration Date | 05/24/2006
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Last Update Date | 09/06/2023
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Provider Practice Location Address
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Address Line | 3450 W 84TH ST SUITE 202M
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City | HIALEAH
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State | FL
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Zip | 33018-4924
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Country | US
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Telephone | 786-315-7718
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Fax |
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Provider Business Mailing Address
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Address Line | 3450 W 84TH ST SUITE 202M
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City | HIALEAH
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State | FL
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Zip | 33018-4924
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Country | US
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Telephone | 786-315-7718
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ADONIS DOMINGUEZ
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Credential |
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Telephone | 786-315-7718
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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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