Provider Demographics
NPI:1356548440
Name:KENDALL OPEN MRI
Entity type:Organization
Organization Name:KENDALL OPEN MRI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CRUZ
Authorized Official - Middle Name:
Authorized Official - Last Name:VERONICA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-596-6242
Mailing Address - Street 1:9280 SW 72ND ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3240
Mailing Address - Country:US
Mailing Address - Phone:305-596-6242
Mailing Address - Fax:305-596-6992
Practice Address - Street 1:9280 SW 72ND ST
Practice Address - Street 2:SUITE 101
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3240
Practice Address - Country:US
Practice Address - Phone:305-596-6242
Practice Address - Fax:305-596-6992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU3386Medicare ID - Type Unspecified