Provider Demographics
NPI:1174638860
Name:STAT DIAGNOSTIC IMAGING INC
Entity Type:Organization
Organization Name:STAT DIAGNOSTIC IMAGING INC
Other - Org Name:DORAL MEDICAL IMAGING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-471-4581
Mailing Address - Street 1:1701 NW 82ND AVE
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33126-1015
Mailing Address - Country:US
Mailing Address - Phone:305-471-4581
Mailing Address - Fax:305-471-4593
Practice Address - Street 1:1701 NW 82ND AVE
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33126-1015
Practice Address - Country:US
Practice Address - Phone:305-471-4581
Practice Address - Fax:305-471-4593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)