Provider Demographics
NPI:1023041217
Name:X-RAY TECHNOLOGY ENTERPRISE INC.
Entity Type:Organization
Organization Name:X-RAY TECHNOLOGY ENTERPRISE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATION
Authorized Official - Prefix:MR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-649-0006
Mailing Address - Street 1:330 SW 27TH AVE
Mailing Address - Street 2:SUITE 708
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-2961
Mailing Address - Country:US
Mailing Address - Phone:305-649-0006
Mailing Address - Fax:305-649-6492
Practice Address - Street 1:330 SW 27TH AVE
Practice Address - Street 2:SUITE 708
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-2961
Practice Address - Country:US
Practice Address - Phone:305-649-0006
Practice Address - Fax:305-649-6492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC4323261Q00000X, 261QR0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Not Answered261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLW9900Medicare ID - Type UnspecifiedPORTABLE X RAY SUPPLIER
FLE1811Medicare ID - Type UnspecifiedIDTF