Provider Demographics
NPI:1326389982
Name:MOBILESONIC IMAGING SERVICES
Entity Type:Organization
Organization Name:MOBILESONIC IMAGING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVAREZ-GOMEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-732-0637
Mailing Address - Street 1:PO BOX 972897
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33197-2897
Mailing Address - Country:US
Mailing Address - Phone:786-732-0637
Mailing Address - Fax:786-732-0637
Practice Address - Street 1:8141 SW 204TH ST
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33189-2650
Practice Address - Country:US
Practice Address - Phone:786-732-0637
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-07
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service