Organization
PRUDENTIAL DIAGNOSTIC CENTER CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUAN C PEREZ DO (PRESIDENT)
(305) 827-9140
Entity
Organization
Contact information
Practice address
900 W 49TH ST, 308, HIALEAH, FL 33012-3402
(305) 827-9140
(305) 827-9143
Mailing address
900 W 49TH ST, 308, HIALEAH, FL 33012-3402
(305) 827-9140
(305) 827-9143
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
HCC7306
FL
Other
Enumeration date
03/25/2009
Last updated
04/29/2009
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