Organization
MIA MOBIL DIAGNOSTIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PROF. DANIEL R FUNDORA CRT (PRESIDENT)
(305) 362-9522
Entity
Organization
Contact information
Practice address
9807 NW 80TH AVE UNIT 11F, HIALEAH, FL 33016-2325
(305) 362-9522
(305) 362-9471
Mailing address
28 MAJORCA AVE APT 4, CORAL GABLES, FL 33134-4603
(305) 362-9522
(305) 362-9471
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
CRT63103
FL
Other
Enumeration date
05/07/2007
Last updated
08/22/2020
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