Organization
MED DIAGNOSTIC CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. WENDY RODRIGUEZ (OWNER)
(305) 858-0808
Entity
Organization
Contact information
Practice address
2455 SW 27TH AVE, SUITE 110, MIAMI, FL 33145-3663
(305) 858-0808
(305) 858-0202
Mailing address
2455 SW 27TH AVE, SUITE 110, MIAMI, FL 33145-3663
(305) 858-0808
(305) 858-0202
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
HCC6620
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HCC6620
AHCA LICENSE NUMBER
FL
Enumeration date
05/04/2006
Last updated
08/22/2020
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