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General NPI Number Information
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NPI Number | 1780566893
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Entity Type | Organization
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Legal Business Name | MILLENNIUM DIAGNOSTIC IMAGING CENTER, INC
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Dates
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Enumeration Date | 07/22/2025
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 8900 SW 24TH ST STE 100
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City | MIAMI
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State | FL
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Zip | 33165-2075
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Country | US
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Telephone | 305-229-9511
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Fax | 305-229-9112
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Provider Business Mailing Address
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Address Line | 8900 SW 24TH ST STE 100
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City | MIAMI
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State | FL
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Zip | 33165-2075
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Country | US
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Telephone | 305-229-9511
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Fax | 305-229-9112
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Authorized Official
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Title or Position | PRESIDENT
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Name | IVETTE DIAZ
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Credential |
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Telephone | 305-229-9115
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0206X
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Taxonomy Name | Mammography Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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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 |
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License Number State |
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