Provider Demographics
NPI:1639221971
Name:LAVOD PORTABLE X RAY INC
Entity Type:Organization
Organization Name:LAVOD PORTABLE X RAY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:ANGEL
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-643-5722
Mailing Address - Street 1:1393 SW 1ST ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-2321
Mailing Address - Country:US
Mailing Address - Phone:305-643-5722
Mailing Address - Fax:
Practice Address - Street 1:1393 SW 1ST ST
Practice Address - Street 2:SUITE 210
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-2321
Practice Address - Country:US
Practice Address - Phone:305-643-5722
Practice Address - Fax:305-643-5728
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier