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General NPI Number Information
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NPI Number | 1700531605
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Entity Type | Organization
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Legal Business Name | ALFA DIAGNOSTIC LLC
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Dates
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Enumeration Date | 02/18/2022
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Last Update Date | 09/06/2023
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Provider Practice Location Address
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Address Line | 21355 E DIXIE HWY STE 107
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City | AVENTURA
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State | FL
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Zip | 33180-1239
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Country | US
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Telephone | 305-705-4775
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Fax |
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Provider Business Mailing Address
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Address Line | 21355 E DIXIE HWY STE 101
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City | AVENTURA
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State | FL
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Zip | 33180-1239
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | OSAMA GOMAA
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Credential |
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Telephone | 727-688-3540
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number |
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License Number State |
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