Provider Demographics
NPI:1003069808
Name:MIDTOWN IMAGING, LLC.
Entity Type:Organization
Organization Name:MIDTOWN IMAGING, LLC.
Other - Org Name:HEALTH DIAGNOSTICS OF AVENTURA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:G
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-697-3001
Mailing Address - Street 1:18851 NE 29TH AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-2808
Mailing Address - Country:US
Mailing Address - Phone:305-932-5554
Mailing Address - Fax:561-209-6377
Practice Address - Street 1:18851 NE 29TH AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-2808
Practice Address - Country:US
Practice Address - Phone:305-932-5554
Practice Address - Fax:561-209-6377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-24
Last Update Date:2009-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology