Provider Demographics
NPI:1154653566
Name:A1A IMAGE
Entity Type:Organization
Organization Name:A1A IMAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NIKORN
Authorized Official - Middle Name:
Authorized Official - Last Name:ARUNAKUL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-316-3744
Mailing Address - Street 1:1421 SW 107TH AVE # 136
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-2526
Mailing Address - Country:US
Mailing Address - Phone:786-316-3744
Mailing Address - Fax:
Practice Address - Street 1:1421 SW 107TH AVE # 136
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-2526
Practice Address - Country:US
Practice Address - Phone:786-316-3744
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-10
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty