Provider Demographics
NPI:1982997623
Name:PREMIER RADIOLOGY SERVICES, LLC
Entity Type:Organization
Organization Name:PREMIER RADIOLOGY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GUILLERMO
Authorized Official - Middle Name:A
Authorized Official - Last Name:PATINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-933-2482
Mailing Address - Street 1:10800 BISCAYNE BLVD
Mailing Address - Street 2:SUITE 810
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-7482
Mailing Address - Country:US
Mailing Address - Phone:305-933-2482
Mailing Address - Fax:305-933-2489
Practice Address - Street 1:10800 BISCAYNE BLVD
Practice Address - Street 2:SUITE 810
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-7482
Practice Address - Country:US
Practice Address - Phone:305-933-2482
Practice Address - Fax:305-933-2489
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-26
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty