Provider Demographics
NPI:1497192892
Name:MIDTOWN DIAGNOSTIC CENTER, LLC
Entity Type:Organization
Organization Name:MIDTOWN DIAGNOSTIC CENTER, LLC
Other - Org Name:MIDTOWN WOMEN'S CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:
Authorized Official - Last Name:LEON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-740-5100
Mailing Address - Street 1:2751 N MIAMI AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33127-4439
Mailing Address - Country:US
Mailing Address - Phone:305-740-5100
Mailing Address - Fax:
Practice Address - Street 1:2751 N MIAMI AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33127-4439
Practice Address - Country:US
Practice Address - Phone:305-740-5100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VITALMD GROUP HOLDINGS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-05-28
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Multi-Specialty