Provider Demographics
NPI:1326604638
Name:SONOSCREENING GABLES CENTER LLC
Entity Type:Organization
Organization Name:SONOSCREENING GABLES CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MNG
Authorized Official - Prefix:
Authorized Official - First Name:LYDIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:ARVELO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-416-1781
Mailing Address - Street 1:75 VALENCIA AVE STE 704
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-6132
Mailing Address - Country:US
Mailing Address - Phone:305-446-4545
Mailing Address - Fax:786-464-9280
Practice Address - Street 1:75 VALENCIA AVE STE 704
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-6132
Practice Address - Country:US
Practice Address - Phone:305-446-4545
Practice Address - Fax:786-464-9280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-13
Last Update Date:2019-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Multi-Specialty