Provider Demographics
NPI:1164761060
Name:ADVANCED MRI AND RADIOLOGY INC
Entity Type:Organization
Organization Name:ADVANCED MRI AND RADIOLOGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-403-4422
Mailing Address - Street 1:8900 SW 107TH AVE
Mailing Address - Street 2:STE 101
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-1451
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8900 SW 107TH AVE
Practice Address - Street 2:STE 101
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1451
Practice Address - Country:US
Practice Address - Phone:305-403-4422
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-12
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology