MEDICARE: SOLUTION DIAGNOSTIC CENTER 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	208D00000X	General Practice Physician	ME64856	FL

General Provider Information

NPI Number	:	1891877429
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOLUTION DIAGNOSTIC CENTER INC

Provider Business Mailing Address
First Line	:	PO BOX 144460
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33114-4460
Country	:	US
Telephone Number	:	305-448-6118
Fax Number	:	305-448-6119

Provider Business Practice Location Address
First Line	:	3970 W FLAGLER ST
Second Line	:	SUITE 204
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-1642
Country	:	US
Telephone Number	:	305-448-6118
Fax Number	:	305-448-6119

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JOSE A LOPEZ
Credential	:
Telephone Number	:	305-448-6118

Provider Enumeration Date	:	10/20/2006
Last Update Date	:	08/22/2020

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