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NPI Code Detail

MEDICARE: B & G DIAGNOSTIC SERVICES INC

MEDICARE: B & G DIAGNOSTIC SERVICES 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
12085R0202XDiagnostic Radiology PhysicianHCC9424FL

General Provider Information

NPI Number : 1831449073
Entity Type Code : Organization
Provider Name (Legal Business Name) : B & G DIAGNOSTIC SERVICES INC
Provider Business Mailing Address
First Line : 472 W 51ST PL
Second Line :
City : HIALEAH
State : FL
Zip : 33012-3620
Country : US
Telephone Number : 305-818-2006
Fax Number : 305-818-2009
Provider Business Practice Location Address
First Line : 472 W 51ST PL
Second Line :
City : HIALEAH
State : FL
Zip : 33012-3620
Country : US
Telephone Number : 305-818-2006
Fax Number : 305-818-2009
Authorized Official
Title or Position : PRESIDENT
Name : MR. BASILIO VALLE
Credential :
Telephone Number : 305-818-2006
Provider Enumeration Date : 09/14/2012
Last Update Date : 09/14/2012

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Directions to “B & G DIAGNOSTIC SERVICES INC ” Practice Location

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