Provider Demographics
NPI:1114535762
Name:CORAL HILLS IMAGING LLC
Entity Type:Organization
Organization Name:CORAL HILLS IMAGING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:F
Authorized Official - Last Name:GUTIERREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-410-8646
Mailing Address - Street 1:9690 W SAMPLE RD STE 103
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-4031
Mailing Address - Country:US
Mailing Address - Phone:954-346-8800
Mailing Address - Fax:954-346-8280
Practice Address - Street 1:9690 W SAMPLE RD STE 103
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-4031
Practice Address - Country:US
Practice Address - Phone:954-346-8800
Practice Address - Fax:954-346-8280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-20
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology