Provider Demographics
NPI:1629185541
Name:DIAGNOSTIC CENTER FOR WOMEN, LLC
Entity Type:Organization
Organization Name:DIAGNOSTIC CENTER FOR WOMEN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:VARONA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-740-5100
Mailing Address - Street 1:7500 SW 87TH AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-5426
Mailing Address - Country:US
Mailing Address - Phone:305-740-5100
Mailing Address - Fax:305-740-5101
Practice Address - Street 1:7500 SW 87TH AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-5426
Practice Address - Country:US
Practice Address - Phone:305-740-5100
Practice Address - Fax:305-740-5101
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VITALMD GROUP HOLDING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-24
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0206XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mammography
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLV2360OtherBC/BS