Provider Demographics
NPI:1336239599
Name:ARCHYS DIAGNOSTIC CENTER INC
Entity Type:Organization
Organization Name:ARCHYS DIAGNOSTIC CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ARNALDO
Authorized Official - Middle Name:
Authorized Official - Last Name:FALCON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-223-0705
Mailing Address - Street 1:35 SW 114TH AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-1002
Mailing Address - Country:US
Mailing Address - Phone:305-223-0705
Mailing Address - Fax:305-223-3237
Practice Address - Street 1:35 SW 114TH AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-1002
Practice Address - Country:US
Practice Address - Phone:305-223-0705
Practice Address - Fax:305-223-3237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2009-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME19976208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL259962700Medicaid
FLK1524Medicare ID - Type Unspecified
FL259962700Medicaid