Provider Demographics
NPI:1982805685
Name:MILLENNIUM RADIOLOGY LLC
Entity Type:Organization
Organization Name:MILLENNIUM RADIOLOGY LLC
Other - Org Name:MILLENNIUM OPEN MRI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROBERTA
Authorized Official - Middle Name:D
Authorized Official - Last Name:KAHANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-773-1403
Mailing Address - Street 1:410 W 45TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-3126
Mailing Address - Country:US
Mailing Address - Phone:305-261-6744
Mailing Address - Fax:305-264-6747
Practice Address - Street 1:7360 CORAL WAY
Practice Address - Street 2:SUITE 27A
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-1498
Practice Address - Country:US
Practice Address - Phone:305-261-6744
Practice Address - Fax:305-264-6747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC5957261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology