Provider Demographics
NPI:1730463274
Name:THERAPY-DIAGNOSTIC, TECH MEDICAL INC.
Entity Type:Organization
Organization Name:THERAPY-DIAGNOSTIC, TECH MEDICAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:DIEGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-262-8811
Mailing Address - Street 1:5870 SW 8TH ST STE 2
Mailing Address - Street 2:
Mailing Address - City:WEST MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-5052
Mailing Address - Country:US
Mailing Address - Phone:305-262-8811
Mailing Address - Fax:305-262-8844
Practice Address - Street 1:5870 SW 8TH ST STE 2
Practice Address - Street 2:
Practice Address - City:WEST MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-5052
Practice Address - Country:US
Practice Address - Phone:305-262-8811
Practice Address - Fax:305-262-8844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-03
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center