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NPI Code Detail

MEDICARE: STAT MOBILE DIAGNOSTICS INC

MEDICARE: STAT MOBILE 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
1261QR0208XMobile Radiology Clinic/Center5747FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1E2241OTHERFLMEDICARE PTAN

General Provider Information

NPI Number : 1326225236
Entity Type Code : Organization
Provider Name (Legal Business Name) : STAT MOBILE DIAGNOSTICS INC
Provider Business Mailing Address
First Line : 2221 NE 164TH ST
Second Line : #290
City : NORTH MIAMI BEACH
State : FL
Zip : 33160-3703
Country : US
Telephone Number : 305-621-7772
Fax Number :
Provider Business Practice Location Address
First Line : 18350 NW 2ND AVE
Second Line : SUITE 400
City : MIAMI
State : FL
Zip : 33169-4519
Country : US
Telephone Number : 305-621-7772
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MR. JORGE LOZANO
Credential : ARRT
Telephone Number : 305-621-7772
Provider Enumeration Date : 01/23/2008
Last Update Date : 01/23/2008

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Directions to “STAT MOBILE DIAGNOSTICS INC ” Practice Location

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