Provider Demographics
| NPI: | 1386946143 |
|---|---|
| Name: | UNIVERSAL IMAGING & RADIOLOGY, LLC |
| Entity type: | Organization |
| Organization Name: | UNIVERSAL IMAGING & RADIOLOGY, LLC |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CEO |
| Authorized Official - Prefix: | DR |
| Authorized Official - First Name: | OLGA |
| Authorized Official - Middle Name: | L |
| Authorized Official - Last Name: | CASANAS, RT |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | RT, ARRT, MR, M, RA |
| Authorized Official - Phone: | 305-821-8585 |
| Mailing Address - Street 1: | 14462 COMMERCE WAY |
| Mailing Address - Street 2: | |
| Mailing Address - City: | MIAMI LAKES |
| Mailing Address - State: | FL |
| Mailing Address - Zip Code: | 33016-1508 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 305-821-8585 |
| Mailing Address - Fax: | 305-821-8586 |
| Practice Address - Street 1: | 14462 COMMERCE WAY |
| Practice Address - Street 2: | |
| Practice Address - City: | MIAMI LAKES |
| Practice Address - State: | FL |
| Practice Address - Zip Code: | 33016-1508 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 305-821-8585 |
| Practice Address - Fax: | 305-821-8586 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2010-11-30 |
| Last Update Date: | 2012-06-06 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| FL | 207RM1200X, 207U00000X, 207UN0902X, 2085B0100X, 2085N0700X, 2085N0904X, 2085P0229X, 2085R0001X, 2085R0203X, 2085R0204X, 2085R0205X, 2085U0001X, 208VP0014X, 261Q00000X | |
| FL | 782006 | 2085R0202X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 2085R0202X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | Group - Multi-Specialty |
| No | 207RM1200X | Allopathic & Osteopathic Physicians | Internal Medicine | Magnetic Resonance Imaging (MRI) | Group - Multi-Specialty |
| No | 207U00000X | Allopathic & Osteopathic Physicians | Nuclear Medicine | Group - Multi-Specialty | |
| No | 207UN0902X | Allopathic & Osteopathic Physicians | Nuclear Medicine | Nuclear Imaging & Therapy | Group - Multi-Specialty |
| No | 2085B0100X | Allopathic & Osteopathic Physicians | Radiology | Body Imaging | Group - Multi-Specialty |
| No | 2085N0700X | Allopathic & Osteopathic Physicians | Radiology | Neuroradiology | Group - Multi-Specialty |
| No | 2085N0904X | Allopathic & Osteopathic Physicians | Radiology | Nuclear Radiology | Group - Multi-Specialty |
| No | 2085P0229X | Allopathic & Osteopathic Physicians | Radiology | Pediatric Radiology | Group - Multi-Specialty |
| No | 2085R0001X | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology | Group - Multi-Specialty |
| No | 2085R0203X | Allopathic & Osteopathic Physicians | Radiology | Therapeutic Radiology | Group - Multi-Specialty |
| No | 2085R0204X | Allopathic & Osteopathic Physicians | Radiology | Vascular & Interventional Radiology | Group - Multi-Specialty |
| No | 2085R0205X | Allopathic & Osteopathic Physicians | Radiology | Radiological Physics | Group - Multi-Specialty |
| No | 2085U0001X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Ultrasound | Group - Multi-Specialty |
| No | 208VP0014X | Allopathic & Osteopathic Physicians | Pain Medicine | Interventional Pain Medicine | Group - Multi-Specialty |
| No | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center | Group - Multi-Specialty |
