Provider Demographics
NPI:1659588879
Name:ALL IMAGES DIAGNOSTIC MEDICAL CENTER INC
Entity Type:Organization
Organization Name:ALL IMAGES DIAGNOSTIC MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:URGUELLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-264-0282
Mailing Address - Street 1:10101 SW 40TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-3947
Mailing Address - Country:US
Mailing Address - Phone:305-553-4765
Mailing Address - Fax:305-553-4769
Practice Address - Street 1:10101 SW 40TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-3947
Practice Address - Country:US
Practice Address - Phone:305-553-4765
Practice Address - Fax:305-553-4769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC6886261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service