MEDICARE: ALL X RAY DIAGNOSTIC SERVICES CORP

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	261Q00000X	Clinic/Center	HCC6652	FL

General Provider Information

NPI Number	:	1659399574
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALL X RAY DIAGNOSTIC SERVICES CORP

Provider Business Mailing Address
First Line	:	4210 NW 4TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-5427
Country	:	US
Telephone Number	:	305-445-9462
Fax Number	:	305-445-9128

Provider Business Practice Location Address
First Line	:	4210 NW 4TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-5427
Country	:	US
Telephone Number	:	305-445-9462
Fax Number	:	305-445-9128

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SABINO FERRO FLORES
Credential	:
Telephone Number	:	305-445-9462

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	12/26/2012

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