Provider Demographics
NPI:1134471048
Name:EXPRESS RADIOLOGY CORP
Entity type:Organization
Organization Name:EXPRESS RADIOLOGY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PD
Authorized Official - Prefix:
Authorized Official - First Name:YOSLAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:VALEDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-414-3232
Mailing Address - Street 1:6095 NW 72ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33166-3737
Mailing Address - Country:US
Mailing Address - Phone:786-414-3232
Mailing Address - Fax:305-885-1728
Practice Address - Street 1:6095 NW 72ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33166-3737
Practice Address - Country:US
Practice Address - Phone:786-414-3232
Practice Address - Fax:305-885-1728
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-03
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiologyGroup - Single Specialty
No171R00000XOther Service ProvidersInterpreterGroup - Single Specialty