Provider Demographics
NPI:1629148622
Name:DIAGNOSTIC ASSOCIATES OF FLORIDA, INC.
Entity Type:Organization
Organization Name:DIAGNOSTIC ASSOCIATES OF FLORIDA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FERNANDO
Authorized Official - Middle Name:ANDRES
Authorized Official - Last Name:BARBERENA
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:954-608-5474
Mailing Address - Street 1:PO BOX 268735
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-8735
Mailing Address - Country:US
Mailing Address - Phone:954-608-5474
Mailing Address - Fax:
Practice Address - Street 1:1920 E HALLANDALE BEACH BLVD
Practice Address - Street 2:SUITE 901
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-4722
Practice Address - Country:US
Practice Address - Phone:954-608-5474
Practice Address - Fax:954-385-2838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC4614261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE1656Medicare ID - Type UnspecifiedIDTF