Provider Demographics
NPI:1427371095
Name:DIMENSIONAL DIAGNOSTIC IMAGING OF MIAMI LLC
Entity Type:Organization
Organization Name:DIMENSIONAL DIAGNOSTIC IMAGING OF MIAMI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RAQUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-608-5549
Mailing Address - Street 1:1740 SW 93RD CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-7739
Mailing Address - Country:US
Mailing Address - Phone:305-608-5549
Mailing Address - Fax:305-553-6825
Practice Address - Street 1:664 E 25TH ST
Practice Address - Street 2:SUITE 103
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-3805
Practice Address - Country:US
Practice Address - Phone:305-608-5549
Practice Address - Fax:305-553-6825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-10
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center