Provider Demographics
NPI:1760914022
Name:RELIABLE IMAGING
Entity Type:Organization
Organization Name:RELIABLE IMAGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:DE JESUS
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:RCS, RVS
Authorized Official - Phone:305-332-3015
Mailing Address - Street 1:7000 SW 62ND AVE
Mailing Address - Street 2:SUITE 525
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-4716
Mailing Address - Country:US
Mailing Address - Phone:305-332-3015
Mailing Address - Fax:305-662-1359
Practice Address - Street 1:7000 SW 62ND AVE
Practice Address - Street 2:SUITE 525
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4716
Practice Address - Country:US
Practice Address - Phone:305-332-3015
Practice Address - Fax:305-662-1359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-28
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL00039495261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service