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Organization
PREMIER DIAGNOSTIC IMAGING SERVICES LLC
Active
Organization
PREMIER DIAGNOSTIC IMAGING SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAUL E MENESES (PRESIDENT)
(305) 467-4448
Entity
Organization
Contact information
Practice address
3595 W 20TH AVE, SUITE 145, HIALEAH, FL 33012-4533
(305) 820-1455
(305) 820-1485
Mailing address
3595 W 20TH AVE, SUITE 145, HIALEAH, FL 33012-4533
(305) 820-1455
(305) 820-1485
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1057548
CARE PLUS
FL
01
—
237861
FDA CERTIFIED MAMMOGRAPHY
—
01
—
306480
AVMED
FL
01
—
375394
WELLCARE
FL
01
—
58201
NEIGHBORHOOD HEALTH PLANS
FL
01
—
5899
MEDICA
FL
01
—
7027683
SUNCOAST HEALTH PLANS
FL
01
—
7051871
AETNA HEALTH PLANS
—
01
—
HCC7443
AHCA CLINIC LICENSE
FL
01
—
SG 082986
VISTA/SUMMIT
FL
Enumeration date
09/22/2006
Last updated
10/07/2007
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