Organization
KNOBLOCH RADIOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ENRIQUE KNOBLOCH MD (MEDICAL DIRECTOR)
(305) 787-5707
Entity
Organization
Contact information
Practice address
2600 WILLIAMS ISLAND BLVD APT 1106, AVENTURA, FL 33160-5209
(305) 787-5707
(954) 753-7972
Mailing address
2600 WILLIAMS ISLAND BLVD APT 1106, AVENTURA, FL 33160-5209
(305) 787-5707
(954) 753-7972
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
Primary
ME61946
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME61946
STATE LICENCE
FL
Enumeration date
05/02/2018
Last updated
05/02/2018
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