Provider Demographics
NPI:1104190149
Name:MRI EXPRESS CORP
Entity Type:Organization
Organization Name:MRI EXPRESS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PD
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:GORGE
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:1877-674-3977
Mailing Address - Street 1:6095 NW 72ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33166-3737
Mailing Address - Country:US
Mailing Address - Phone:187-767-4397
Mailing Address - Fax:
Practice Address - Street 1:6095 NW 72ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33166-3737
Practice Address - Country:US
Practice Address - Phone:187-767-4397
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-07
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory