Provider Demographics
NPI: | 1740487586 |
---|---|
Name: | EIBER RADIOLOGY |
Entity type: | Organization |
Organization Name: | EIBER RADIOLOGY |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | ADMINISTRATOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | OLGA |
Authorized Official - Middle Name: | L |
Authorized Official - Last Name: | CASANAS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | RT, MR, ARRT, RA |
Authorized Official - Phone: | 786-319-0707 |
Mailing Address - Street 1: | 99 W 49TH ST |
Mailing Address - Street 2: | |
Mailing Address - City: | HIALEAH |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 33012-3709 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 786-319-0707 |
Mailing Address - Fax: | 305-817-6490 |
Practice Address - Street 1: | 7180 N UNIVERSITY DR |
Practice Address - Street 2: | SUITE 130 |
Practice Address - City: | TAMARAC |
Practice Address - State: | FL |
Practice Address - Zip Code: | 33321-2916 |
Practice Address - Country: | US |
Practice Address - Phone: | 954-718-4560 |
Practice Address - Fax: | 954-718-4561 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-06-27 |
Last Update Date: | 2020-08-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
FL | K3166 | 207RM1200X, 207U00000X, 207UN0901X, 2085B0100X, 2085D0003X, 2085N0700X, 2085N0904X, 2085R0001X, 2085R0202X, 2085R0204X, 2085R0205X, 2085U0001X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Not Answered | 207RM1200X | Allopathic & Osteopathic Physicians | Internal Medicine | Magnetic Resonance Imaging (MRI) | Group - Single Specialty |
Not Answered | 207U00000X | Allopathic & Osteopathic Physicians | Nuclear Medicine | Group - Single Specialty | |
Not Answered | 207UN0901X | Allopathic & Osteopathic Physicians | Nuclear Medicine | Nuclear Cardiology | Group - Single Specialty |
Not Answered | 2085B0100X | Allopathic & Osteopathic Physicians | Radiology | Body Imaging | Group - Single Specialty |
Not Answered | 2085D0003X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Neuroimaging | Group - Single Specialty |
Not Answered | 2085N0700X | Allopathic & Osteopathic Physicians | Radiology | Neuroradiology | Group - Single Specialty |
Not Answered | 2085N0904X | Allopathic & Osteopathic Physicians | Radiology | Nuclear Radiology | Group - Single Specialty |
Not Answered | 2085R0001X | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology | Group - Single Specialty |
Not Answered | 2085R0202X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | Group - Single Specialty |
Not Answered | 2085R0204X | Allopathic & Osteopathic Physicians | Radiology | Vascular & Interventional Radiology | Group - Single Specialty |
Not Answered | 2085R0205X | Allopathic & Osteopathic Physicians | Radiology | Radiological Physics | Group - Single Specialty |
Not Answered | 2085U0001X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Ultrasound | Group - Single Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
FL | HCC4928 CERT.# 5354 | Other | HEALTH CARE CLINIC EXEMPT |
FL | HCC4928 CERT.# 5354 | Other | HEALTH CARE CLINIC EXEMPT |