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General NPI Number Information
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NPI Number | 1689924292
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Entity Type | Organization
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Legal Business Name | BREAST DIAGNOSTICS
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Dates
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Enumeration Date | 09/12/2012
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Last Update Date | 09/12/2012
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Provider Practice Location Address
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Address Line | 21355 E DIXIE HWY #117
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City | AVENTURA
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State | FL
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Zip | 33180-1238
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Country | US
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Telephone | 305-932-0282
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Fax | 877-635-1453
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Provider Business Mailing Address
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Address Line | 21355 E DIXIE HWY #117
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City | AVENTURA
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State | FL
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Zip | 33180-1238
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Country | US
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Telephone | 305-932-0282
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Fax | 877-635-1453
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. VILMA BIAGGI
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Credential | M.D.
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Telephone | 305-932-0282
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | ME43242
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License Number State | FL
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