Provider Demographics
NPI:1912287269
Name:JAY DIAGNOSTIC & REHAB. CENTER
Entity Type:Organization
Organization Name:JAY DIAGNOSTIC & REHAB. CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:MERAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-536-5358
Mailing Address - Street 1:742 E 10TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-3636
Mailing Address - Country:US
Mailing Address - Phone:786-536-5358
Mailing Address - Fax:786-536-5484
Practice Address - Street 1:742 E 10TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-3636
Practice Address - Country:US
Practice Address - Phone:786-536-5358
Practice Address - Fax:786-536-5484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-18
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLBMO65089261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology