Provider Demographics
NPI:1114962065
Name:HIGH QUALITY XRAY SERVICE CORP
Entity Type:Organization
Organization Name:HIGH QUALITY XRAY SERVICE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:A
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-265-2050
Mailing Address - Street 1:5757 SW 8TH ST
Mailing Address - Street 2:SUITE# 119
Mailing Address - City:WEST MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-5060
Mailing Address - Country:US
Mailing Address - Phone:305-265-2050
Mailing Address - Fax:
Practice Address - Street 1:5757 SW 8TH ST
Practice Address - Street 2:SUITE# 119
Practice Address - City:WEST MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-5060
Practice Address - Country:US
Practice Address - Phone:305-265-2050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Not Answered261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning FacilityGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME89783OtherMARIANO S. LACAYO, MD