Provider Demographics
NPI:1235216243
Name:PND MEDICAL SERVICES CORP
Entity Type:Organization
Organization Name:PND MEDICAL SERVICES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:N
Authorized Official - Last Name:DIUANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-597-6837
Mailing Address - Street 1:10491 N KENDALL DR
Mailing Address - Street 2:SUITE F 210
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-1533
Mailing Address - Country:US
Mailing Address - Phone:786-597-6837
Mailing Address - Fax:305-598-0019
Practice Address - Street 1:10491 N KENDALL DR
Practice Address - Street 2:SUITE F 210
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1533
Practice Address - Country:US
Practice Address - Phone:786-597-6837
Practice Address - Fax:305-598-0019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAHCA HCC6959261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHCC6959OtherAHCA LICENSE