Provider Demographics
NPI:1205075702
Name:MEDICAL DIAGNOSTICS INTERNATIONAL
Entity type:Organization
Organization Name:MEDICAL DIAGNOSTICS INTERNATIONAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:FELIPE
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:786-586-5062
Mailing Address - Street 1:13500 SW 88TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-1515
Mailing Address - Country:US
Mailing Address - Phone:786-624-0014
Mailing Address - Fax:786-507-7770
Practice Address - Street 1:13500 SW 88TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-1515
Practice Address - Country:US
Practice Address - Phone:786-624-0014
Practice Address - Fax:786-507-7770
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CORTEZ SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-02-07
Last Update Date:2009-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLG09002900058293D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory