Provider Demographics
NPI:1346407616
Name:FLORIDA MOBILE IMAGING SERVICES INC
Entity Type:Organization
Organization Name:FLORIDA MOBILE IMAGING SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:VITON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-649-0470
Mailing Address - Street 1:3260 NW 7TH ST STE 102
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-4102
Mailing Address - Country:US
Mailing Address - Phone:305-649-0470
Mailing Address - Fax:305-649-0620
Practice Address - Street 1:3260 NW 7TH ST STE 102
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-4102
Practice Address - Country:US
Practice Address - Phone:305-649-0470
Practice Address - Fax:305-649-0620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-22
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLW9929Medicare PIN