Provider Demographics
NPI:1518384080
Name:REMASUR USA LLC
Entity Type:Organization
Organization Name:REMASUR USA LLC
Other - Org Name:DORAL RADIOLOGY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:L
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-892-4470
Mailing Address - Street 1:3470 NW 82ND AVE
Mailing Address - Street 2:SUITE 119
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33122-1024
Mailing Address - Country:US
Mailing Address - Phone:305-592-0093
Mailing Address - Fax:305-592-0098
Practice Address - Street 1:3470 NW 82ND AVE
Practice Address - Street 2:SUITE 119
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33122-1024
Practice Address - Country:US
Practice Address - Phone:305-592-0093
Practice Address - Fax:305-592-0098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-23
Last Update Date:2014-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
No261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
No261QR0206XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mammography
No261QX0203XAmbulatory Health Care FacilitiesClinic/CenterOncology, Radiation