Provider Demographics
NPI:1366469272
Name:PVD DIAGNOSTICS INC
Entity Type:Organization
Organization Name:PVD DIAGNOSTICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-820-7003
Mailing Address - Street 1:6447 MIAMI LAKES DR E
Mailing Address - Street 2:SUITE 225C
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-2741
Mailing Address - Country:US
Mailing Address - Phone:305-820-7003
Mailing Address - Fax:
Practice Address - Street 1:6447 MIAMI LAKES DR E
Practice Address - Street 2:SUITE 225C
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2741
Practice Address - Country:US
Practice Address - Phone:305-820-7003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty