MEDICARE: ASSOCIATED RADIOLOGY DIAGNOCTIC, 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	261QR0200X	Radiology Clinic/Center

General Provider Information

NPI Number	:	1699791632
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASSOCIATED RADIOLOGY DIAGNOCTIC, INC

Provider Business Mailing Address
First Line	:	974 SW 82ND AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33144-4271
Country	:	US
Telephone Number	:	305-267-6145
Fax Number	:	305-267-6174

Provider Business Practice Location Address
First Line	:	974 SW 82ND AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33144-4271
Country	:	US
Telephone Number	:	305-267-6145
Fax Number	:	305-267-6174

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. ELIZABETH M VERDE
Credential	:
Telephone Number	:	305-267-6145

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	08/22/2020

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