Provider Demographics
NPI:1336213040
Name:BAY IMAGING GROUP INC
Entity Type:Organization
Organization Name:BAY IMAGING GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:HANK
Authorized Official - Middle Name:
Authorized Official - Last Name:KOCHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-891-1900
Mailing Address - Street 1:1755 NE 127TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-2518
Mailing Address - Country:US
Mailing Address - Phone:305-891-1900
Mailing Address - Fax:305-891-1911
Practice Address - Street 1:1755 NE 127TH ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-2518
Practice Address - Country:US
Practice Address - Phone:305-891-1900
Practice Address - Fax:305-891-1911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC5519261QR0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0206XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mammography
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE8220Medicare ID - Type Unspecified