MEDICARE: E.S.R. DIAGNOSTICS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	246ZE0600X	Electroneurodiagnostic Specialist/Technologist

General Provider Information

NPI Number	:	1144480351
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	E.S.R. DIAGNOSTICS, INC.

Provider Business Mailing Address
First Line	:	899 SW 86TH CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33144-4028
Country	:	US
Telephone Number	:	305-267-6600
Fax Number	:	305-267-4001

Provider Business Practice Location Address
First Line	:	899 SW 86TH CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33144-4028
Country	:	US
Telephone Number	:	305-267-6600
Fax Number	:	305-267-4001

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ERNESTO S RODRIGUEZ
Credential	:
Telephone Number	:	305-267-6600

Provider Enumeration Date	:	06/11/2008
Last Update Date	:	06/11/2008

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