MEDICARE: DIGITAL MEDICAL 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	293D00000X	Physiological Laboratory

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	E4054A	OTHER	FL	MEDICARE MOBILE MRI

General Provider Information

NPI Number	:	1558606525
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIGITAL MEDICAL DIAGNOSTICS INC

Provider Business Mailing Address
First Line	:	41 TAMIAMI CANAL RD
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33144-2538
Country	:	US
Telephone Number	:	305-269-0833
Fax Number	:	305-269-0851

Provider Business Practice Location Address
First Line	:	41 TAMIAMI CANAL RD
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33144-2538
Country	:	US
Telephone Number	:	305-269-0833
Fax Number	:	305-269-0851

Authorized Official
Title or Position	:	VICE-PRESIDENT
Name	:	MR. ERICK E MARTINEZ
Credential	:
Telephone Number	:	786-367-3554

Provider Enumeration Date	:	12/03/2012
Last Update Date	:	08/05/2013

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Directions to “DIGITAL MEDICAL DIAGNOSTICS INC ” Practice Location

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