Organization
DIAGNOSTIC PORTABLE LAB
Active
Organization
DIAGNOSTIC PORTABLE LAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ENRIQUE HANABERGH MD (PRESIDENT)
(305) 931-7884
Entity
Organization
Contact information
Practice address
21110 BISCAYNE BLVD, STE 206, AVENTURA, FL 33180-1227
(301) 931-7884
(305) 933-3203
Mailing address
21110 BISCAYNE BLVD, STE 206, AVENTURA, FL 33180-1227
(301) 931-7884
(305) 933-3203
Taxonomy
Speciality
Code
Description
License number
State
246XC2903X
Vascular Specialist/Technologist Cardiovascular
—
—
246XS1301X
Sonography Specialist/Technologist Cardiovascular
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
V1034
BCBS
FL
Enumeration date
09/12/2005
Last updated
09/11/2025
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