Provider Demographics
NPI:1942535687
Name:AB DIAGNOSTIC CENTER INC
Entity Type:Organization
Organization Name:AB DIAGNOSTIC CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:CARLOS
Authorized Official - Last Name:ARAGON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-687-8780
Mailing Address - Street 1:3803 NW 125TH ST
Mailing Address - Street 2:
Mailing Address - City:OPA LOCKA
Mailing Address - State:FL
Mailing Address - Zip Code:33054-4515
Mailing Address - Country:US
Mailing Address - Phone:305-687-8780
Mailing Address - Fax:305-687-8896
Practice Address - Street 1:3803 NW 125TH ST
Practice Address - Street 2:
Practice Address - City:OPA LOCKA
Practice Address - State:FL
Practice Address - Zip Code:33054-4515
Practice Address - Country:US
Practice Address - Phone:305-687-8780
Practice Address - Fax:305-687-8896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-14
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC6403261QM1200X, 261QR0200X, 261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
No261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
No261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic