Provider Demographics
NPI:1649341439
Name:SOUTH MIAMI 3 DIMENSIONAL INSTITUTE INC
Entity type:Organization
Organization Name:SOUTH MIAMI 3 DIMENSIONAL INSTITUTE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PD
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:PINERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-828-1070
Mailing Address - Street 1:6201 SW 70TH ST STE 103
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-4718
Mailing Address - Country:US
Mailing Address - Phone:305-828-1070
Mailing Address - Fax:305-828-8208
Practice Address - Street 1:6201 SW 70TH ST STE 103
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4718
Practice Address - Country:US
Practice Address - Phone:305-828-1070
Practice Address - Fax:305-828-8208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU2817Medicare ID - Type Unspecified