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General NPI Number Information
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NPI Number | 1932493426
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Entity Type | Organization
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Legal Business Name | T & A DIAGNOSTIC CENTER, INC
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Dates
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Enumeration Date | 06/02/2011
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Last Update Date | 06/02/2011
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Provider Practice Location Address
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Address Line | 6465 SW 8TH ST
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City | WEST MIAMI
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State | FL
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Zip | 33144-4843
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Country | US
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Telephone | 305-456-0813
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Fax |
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Provider Business Mailing Address
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Address Line | 6465 SW 8TH ST
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City | WEST MIAMI
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State | FL
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Zip | 33144-4843
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Country | US
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Telephone | 305-456-0813
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JUAN C PINO
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Credential |
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Telephone | 305-456-0813
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | HCC8216
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License Number State | FL
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