Organization
BREAST & ULTRASOUND DIAGNOSTIC SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARLOS EXPOSITO (PRESIDENT)
(305) 558-4140
Entity
Organization
Contact information
Practice address
4980 W 10TH AVE, SUITE 102, HIALEAH, FL 33012-3437
(305) 558-4140
(305) 558-9698
Mailing address
4980 W 10TH AVE, SUITE 102, HIALEAH, FL 33012-3437
(305) 558-4140
(305) 558-9698
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
HCC4409
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
170998
WELLCARE STAYWELL
FL
01
—
216622
AMERIGROUP
FL
01
—
257947
AVMED
FL
01
—
77793
BCBS
FL
Enumeration date
12/21/2006
Last updated
08/22/2020
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