Provider Demographics
NPI:1396971354
Name:IMAGING RX, LLC
Entity type:Organization
Organization Name:IMAGING RX, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR / MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HERIBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:PENA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-247-3775
Mailing Address - Street 1:13250 SW 131ST ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-5870
Mailing Address - Country:US
Mailing Address - Phone:305-964-0100
Mailing Address - Fax:305-647-6427
Practice Address - Street 1:13250 SW 131ST ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-5870
Practice Address - Country:US
Practice Address - Phone:305-964-0100
Practice Address - Fax:305-647-6427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-04
Last Update Date:2009-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL8CC7509261QR0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile