Provider Demographics
NPI:1437572658
Name:LYRON DIAGNOSTIC CENTER CORP
Entity Type:Organization
Organization Name:LYRON DIAGNOSTIC CENTER CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LIRON
Authorized Official - Middle Name:
Authorized Official - Last Name:BELTZER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-964-7618
Mailing Address - Street 1:19100 SW 177TH AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33187-2021
Mailing Address - Country:US
Mailing Address - Phone:305-964-7618
Mailing Address - Fax:786-732-0473
Practice Address - Street 1:19100 SW 177TH AVE STE 3
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33187-2021
Practice Address - Country:US
Practice Address - Phone:305-964-7618
Practice Address - Fax:786-732-0473
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-23
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME105585261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service