Organization
MIA DIAGNOSTICS OF SOUTH FLORIDA CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAUL M PARDO (PRESIDENT)
(786) 262-6143
Entity
Organization
Contact information
Practice address
9745 SW 72ND ST, SUITE 115, MIAMI, FL 33173-4652
(305) 630-9252
(305) 630-9241
Mailing address
9745 SW 72ND ST, SUITE 115, MIAMI, FL 33173-4652
(305) 630-9252
(305) 630-9241
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HCC7500
HCC LICENSE
FL
Enumeration date
02/02/2007
Last updated
11/03/2008
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