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Organization
IDEAL DIAGNOSTIC CENTER INC
Active
Organization
IDEAL DIAGNOSTIC CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
INGRID CIFUENTES BRUCE LMT (OWNER/THERAPIST)
(305) 444-0137
Entity
Organization
Contact information
Practice address
3623 SW 3RD ST, MIAMI, FL 33135-2543
(305) 444-0137
(305) 444-0137
Mailing address
PO BOX 350966, MIAMI, FL 33135-0966
(305) 444-0137
(305) 444-0137
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
MA 61215
FL
Other
Enumeration date
01/10/2011
Last updated
01/12/2011
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