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General NPI Number Information
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NPI Number | 1760627533
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Entity Type | Organization
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Legal Business Name | PAN AM DIAGNOSTIC SERVICES, INC.
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Dates
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Enumeration Date | 12/09/2008
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Last Update Date | 12/09/2008
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Provider Practice Location Address
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Address Line | 6421 MILNER BLVD SUITE 1
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City | ORLANDO
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State | FL
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Zip | 32809-6669
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Country | US
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Telephone | 407-857-1700
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Fax | 407-857-1600
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Provider Business Mailing Address
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Address Line | 410 W 45TH ST
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City | MIAMI BEACH
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State | FL
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Zip | 33140-3126
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Country | US
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Telephone | 305-773-1403
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. ROBERTA D. KAHANA
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Credential |
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Telephone | 305-773-1403
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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 | HCC7181
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License Number State | FL
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