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Organization
LIFE RADIOLOGY LLC
Active
Organization
LIFE RADIOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEX ALONSO M.D (MGR)
(786) 446-8541
Entity
Organization
Contact information
Practice address
3470 NW 82ND AVE, SUITE 119, DORAL, FL 33122-1024
(786) 446-8541
(786) 446-8542
Mailing address
5901 SW 114TH TER, PINECREST, FL 33156-5030
(786) 446-8541
(786) 446-8542
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
ME84005
FL
261QR0200X
Radiology Clinic/Center
Primary
ME84005
FL
261QR0206X
Mammography Clinic/Center
ME84005
FL
Other
Enumeration date
09/08/2016
Last updated
01/30/2017
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