Organization
MILLENNIUM DIAGNOSTIC IMAGING CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. IVETTE DIAZ (PRESIDENT)
(305) 229-9115
Entity
Organization
Contact information
Practice address
8900 SW 24TH ST, SUITE 100, MIAMI, FL 33165-2075
(305) 229-9511
(305) 229-9112
Mailing address
8900 SW 24TH ST, SUITE 100, MIAMI, FL 33165-2075
(305) 229-9511
(305) 229-9112
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
HCC4575
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
126302500
—
FL
01
—
246371
WELLCARE
FL
01
—
261893100
FLORIDA NET PASS
FL
01
—
272346
AMERIGROUP
FL
01
—
292178
AVMED
FL
01
—
V2847
BLUE CROSS BLUE SHIELD
FL
Enumeration date
08/14/2006
Last updated
07/03/2025
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