Provider Demographics
NPI:1952584047
Name:MOBILE DIOGNOSTIC SOLUTIONS LLC.
Entity Type:Organization
Organization Name:MOBILE DIOGNOSTIC SOLUTIONS LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:JUGUILON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-781-7077
Mailing Address - Street 1:3695 WASHINGTON PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44105-3177
Mailing Address - Country:US
Mailing Address - Phone:440-781-7177
Mailing Address - Fax:
Practice Address - Street 1:3695 WASHINGTON PARK BLVD
Practice Address - Street 2:
Practice Address - City:NEWBURGH HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44105-3177
Practice Address - Country:US
Practice Address - Phone:440-781-7177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-11
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Single Specialty