Provider Demographics
NPI:1578776837
Name:PERFECT DIAGNOSTIC SERVICES, CO
Entity Type:Organization
Organization Name:PERFECT DIAGNOSTIC SERVICES, CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:JURADO IGLESIAS
Authorized Official - Suffix:
Authorized Official - Credentials:ARDMS
Authorized Official - Phone:786-326-8107
Mailing Address - Street 1:22218 SW 58TH AVE
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428
Mailing Address - Country:US
Mailing Address - Phone:786-326-8107
Mailing Address - Fax:561-483-3901
Practice Address - Street 1:6366 CORAL WAY
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155
Practice Address - Country:US
Practice Address - Phone:786-326-8107
Practice Address - Fax:305-662-1425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2007-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARAMS 1017562085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Multi-Specialty