Organization
CARDIOVASCULAR DIAGNOSTIC IMAGE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDELIO MIRABOLO (OWNER)
(305) 480-2000
Entity
Organization
Contact information
Practice address
7171 SW 24TH ST, SUITE 311, MIAMI, FL 33155-1692
(305) 480-2000
(305) 480-2003
Mailing address
7171 SW 24TH ST, SUITE 311, MIAMI, FL 33155-1692
(305) 480-2000
(305) 480-2003
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
HCC10640
FL
261QM1300X
Multi-Specialty Clinic/Center
HCC6687
FL
261QR0206X
Mammography Clinic/Center
HCC10640
FL
261QR0206X
Mammography Clinic/Center
Primary
HCC6687
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
261881800
—
FL
Enumeration date
02/14/2007
Last updated
05/13/2016
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