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General NPI Number Information
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NPI Number | 1821262494
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Entity Type | Organization
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Legal Business Name | P E T - CT & MRI OF MIAMI LLC
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Dates
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Enumeration Date | 04/15/2008
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Last Update Date | 03/09/2023
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Provider Practice Location Address
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Address Line | 12905 SW 42ND ST STE 106
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City | MIAMI
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State | FL
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Zip | 33175-2905
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Country | US
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Telephone | 305-229-2020
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Fax | 305-229-2218
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Provider Business Mailing Address
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Address Line | 12905 SW 42ND ST STE 106
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City | MIAMI
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State | FL
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Zip | 33175-2905
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Country | US
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Telephone | 305-229-2020
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Fax | 305-229-2218
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Authorized Official
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Title or Position | MGRM
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Name | DR. KEILA HOOVER
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Credential |
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Telephone | 305-458-0211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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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 | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | HCC8124
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License Number State | FL
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