Organization
DIAGNOSTIC SERVICE CENTER OF NORTH MIAMI BEACH LLC
Active
Other names
FOUNTAIN IMAGING
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHARON TREMBLAY (BUSINESS DEVELOPMENT)
(305) 770-4343
Entity
Organization
Contact information
Practice address
1 NE 167TH ST, NORTH MIAMI BEACH, FL 33162-3402
(305) 770-4343
(305) 770-4343
Mailing address
88 NE 168TH ST, NORTH MIAMI BEACH, FL 33162-3410
(305) 770-4343
(305) 770-4373
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
HCC6911
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
319618
AVMED
FL
01
—
64817
NEIGHBORHOOD HEALTH PLAN
FL
01
—
F300153
FREEDOM HEALTH
FL
01
—
V3305
BLUE CROSS BLUE SHIELD
FL
Enumeration date
03/17/2008
Last updated
12/03/2008
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