Provider Demographics
NPI:1225423767
Name:MOBILTECH DIAGNOSTIC CENTER INC
Entity Type:Organization
Organization Name:MOBILTECH DIAGNOSTIC CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MIRNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MANCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-917-5108
Mailing Address - Street 1:22161 SW 88TH PATH
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33190-1209
Mailing Address - Country:US
Mailing Address - Phone:305-917-5108
Mailing Address - Fax:786-603-7593
Practice Address - Street 1:22161 SW 88TH PATH
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33190-1209
Practice Address - Country:US
Practice Address - Phone:305-917-5108
Practice Address - Fax:786-603-7593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-01
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service