Organization
IN HIS IMAGE MEDICAL, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD ANTHONY BONILLA RCS, CVT (OWNER/PRESIDENT)
(305) 345-2055
Entity
Organization
Contact information
Practice address
13550 SW 88TH ST STE 180, MIAMI, FL 33186-1513
(305) 381-2868
Mailing address
16510 SW 96TH TER, MIAMI, FL 33196-5832
(305) 345-2055
(305) 388-3182
Taxonomy
Speciality
Code
Description
License number
State
261QR0208X
Mobile Radiology Clinic/Center
Primary
00069740
FL
Other
Enumeration date
02/04/2009
Last updated
04/21/2020
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