Provider Demographics
NPI:1891877429
Name:SOLUTION DIAGNOSTIC CENTER INC
Entity Type:Organization
Organization Name:SOLUTION DIAGNOSTIC CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:A
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-448-6118
Mailing Address - Street 1:PO BOX 144460
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33114-4460
Mailing Address - Country:US
Mailing Address - Phone:305-448-6118
Mailing Address - Fax:305-448-6119
Practice Address - Street 1:3970 W FLAGLER ST
Practice Address - Street 2:SUITE 204
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-1642
Practice Address - Country:US
Practice Address - Phone:305-448-6118
Practice Address - Fax:305-448-6119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME64856208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherEMPLOYER IDENTIFICATION N