Provider Demographics
NPI:1114468402
Name:NAVARRO MOBILE IMAGING CORP.
Entity Type:Organization
Organization Name:NAVARRO MOBILE IMAGING CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:
Authorized Official - First Name:ALEJANDRA
Authorized Official - Middle Name:BEATRIZ
Authorized Official - Last Name:RAFTACCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-600-6815
Mailing Address - Street 1:100 BAYVIEW DR
Mailing Address - Street 2:APARTMENT :211
Mailing Address - City:SUNNY ISLES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-4781
Mailing Address - Country:US
Mailing Address - Phone:305-600-6815
Mailing Address - Fax:
Practice Address - Street 1:100 BAYVIEW DRIVE
Practice Address - Street 2:APARTMENT :211
Practice Address - City:SUNNY ISLES BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-4781
Practice Address - Country:US
Practice Address - Phone:305-600-6815
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-20
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCRT 33351261QR0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile