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Organization
DIAGNOSTIC SERVICE CENTER OF NORTH MIAMI BEACH LLC
Active
Organization
DIAGNOSTIC SERVICE CENTER OF NORTH MIAMI BEACH LLC
Active
Other names
FOUNTAIN IMAGING
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHARON TREMBLAY (BUSINESS DEVELOPMENT)
(305) 770-4343
Entity
Organization
Contact information
Practice address
1 NE 167TH ST, NORTH MIAMI BEACH, FL 33162-3402
(305) 770-4343
(305) 770-4343
Mailing address
88 NE 168TH ST, NORTH MIAMI BEACH, FL 33162-3410
(305) 770-4343
(305) 770-4373
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
HCC6911
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
319618
AVMED
FL
01
—
64817
NEIGHBORHOOD HEALTH PLAN
FL
01
—
F300153
FREEDOM HEALTH
FL
01
—
V3305
BLUE CROSS BLUE SHIELD
FL
Enumeration date
03/17/2008
Last updated
12/03/2008
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