Provider Demographics
NPI:1386680254
Name:TLC DIAGNOSTIC CORP
Entity Type:Organization
Organization Name:TLC DIAGNOSTIC CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ABIGAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:AGUILA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-260-0786
Mailing Address - Street 1:7105 SW 8TH ST
Mailing Address - Street 2:SUITE # 302
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-4664
Mailing Address - Country:US
Mailing Address - Phone:305-260-0786
Mailing Address - Fax:305-260-0783
Practice Address - Street 1:7105 SW 8TH ST
Practice Address - Street 2:SUITE # 302
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-4664
Practice Address - Country:US
Practice Address - Phone:305-260-0786
Practice Address - Fax:305-260-0783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile