Provider Demographics
NPI:1043246911
Name:QUALITY DIAGNOSTIC & MEDICAL CENTER INC.
Entity Type:Organization
Organization Name:QUALITY DIAGNOSTIC & MEDICAL CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:MENENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:954-792-7113
Mailing Address - Street 1:1567 SE 20 ROAD
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:LA
Mailing Address - Zip Code:33035
Mailing Address - Country:US
Mailing Address - Phone:305-230-6620
Mailing Address - Fax:
Practice Address - Street 1:121 SOUTH STATE ROAD 7
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317
Practice Address - Country:US
Practice Address - Phone:954-792-7113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service