Provider Demographics
NPI:1275998254
Name:ULTRASOUND IMAGING SERVICES, INC
Entity Type:Organization
Organization Name:ULTRASOUND IMAGING SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ULTRASOUND TECHNICIAN
Authorized Official - Prefix:
Authorized Official - First Name:GRETHER
Authorized Official - Middle Name:
Authorized Official - Last Name:PIEDRA
Authorized Official - Suffix:
Authorized Official - Credentials:ARDMS
Authorized Official - Phone:305-496-1229
Mailing Address - Street 1:11803 SW 14TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33184-2514
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11803 SW 14TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33184-2514
Practice Address - Country:US
Practice Address - Phone:305-496-1229
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-17
Last Update Date:2015-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARDMS 152632261QR0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile