Provider Demographics
NPI:1619382447
Name:MDC DIAGNOSTICS & THERAPUETICS
Entity Type:Organization
Organization Name:MDC DIAGNOSTICS & THERAPUETICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:IGELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-596-6907
Mailing Address - Street 1:9055 SW 87TH AVE
Mailing Address - Street 2:SUITE 308
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2306
Mailing Address - Country:US
Mailing Address - Phone:305-596-6907
Mailing Address - Fax:305-596-6905
Practice Address - Street 1:9055 SW 87TH AVE
Practice Address - Street 2:SUITE 308
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2306
Practice Address - Country:US
Practice Address - Phone:305-596-6907
Practice Address - Fax:305-596-6905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-01
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental MedicineGroup - Single Specialty