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NPI Code Detail

MEDICARE: GABLES DIAGNOSTIC TESTING GROUP INC

MEDICARE: GABLES DIAGNOSTIC TESTING GROUP 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
1261QM1200XMagnetic Resonance Imaging (MRI) Clinic/Center
2261QM1300XMulti-Specialty Clinic/Center
3261QR0200XRadiology Clinic/Center

General Provider Information

NPI Number : 1770706301
Entity Type Code : Organization
Provider Name (Legal Business Name) : GABLES DIAGNOSTIC TESTING GROUP INC
Provider Business Mailing Address
First Line : 9485 SW 72ND ST
Second Line : SUITE A150
City : MIAMI
State : FL
Zip : 33173-3242
Country : US
Telephone Number : 305-275-6069
Fax Number : 305-412-8265
Provider Business Practice Location Address
First Line : 802 DOUGLAS ROAD
Second Line : SUITE 150
City : CORAL GABLES
State : FL
Zip : 33134-3242
Country : US
Telephone Number : 305-441-8800
Fax Number : 305-445-4301
Authorized Official
Title or Position : PRESIDENT
Name : MR. STEPHEN E CIANCIULLI
Credential :
Telephone Number : 305-275-6069
Provider Enumeration Date : 04/11/2007
Last Update Date : 05/13/2008

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Directions to “GABLES DIAGNOSTIC TESTING GROUP INC ” Practice Location

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