Provider Demographics
NPI:1275651291
Name:RT DIAGNOSTIC INC.
Entity Type:Organization
Organization Name:RT DIAGNOSTIC INC.
Other - Org Name:D/B/A CLINICA LA SALUD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT - OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:DELGADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-559-2121
Mailing Address - Street 1:8415 SW 24TH ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-2305
Mailing Address - Country:US
Mailing Address - Phone:305-559-2121
Mailing Address - Fax:305-559-4071
Practice Address - Street 1:8415 SW 24TH ST
Practice Address - Street 2:SUITE 203
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-2305
Practice Address - Country:US
Practice Address - Phone:305-559-2121
Practice Address - Fax:305-559-4071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS4095174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLIN395AMedicare PIN