# EXELSIOR DIAGNOSTIC SERVICE, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699179176
- **Authorized official:** ALEXANDER TIRADO PA-C (PRESIDENT)
- **Authorized official phone:** (305) 944-1122

## Contact information

- **Practice address:** 951 NE 167TH ST, SUITE 102, NORTH MIAMI BEACH, FL 33162-3711
- **Practice address phone:** (305) 944-1122
- **Practice address fax:** (305) 944-1133
- **Mailing address:** 951 NE 167TH ST, SUITE 102, NORTH MIAMI BEACH, FL 33162-3711
- **Mailing address phone:** (305) 944-1122
- **Mailing address fax:** (305) 944-1133

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | ME58497 | FL | Yes |

## Other

- **Enumeration date:** 10/13/2014
- **Last updated:** 10/13/2014