NPIMap

Organization Active NPI

Prudential Diagnostic Center Corp.

  • Health Service Clinic/Center
  • Hialeah, FL
National Provider Identifier
1255573002
Registry record updated Apr 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
HCC7306 Issued in FL
Legal business name
PRUDENTIAL DIAGNOSTIC CENTER CORP.
Practice address
900 W 49TH St
308
Hialeah, FL 33012-3402
Phone
(305) 827-9140
Fax
(305) 827-9143
NPI assigned
Mar 25, 2009
Last updated
Apr 29, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Juan C Perez, DO
Title
President
Phone
(305) 827-9140

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X HCC7306 FL Primary

Addresses

Primary practice location

900 W 49TH St
308
Hialeah, FL 33012-3402

Mailing address

900 W 49TH St
308
Hialeah, FL 33012-3402
Phone (305) 827-9140

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1237939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240963200000",
    "number": "1255573002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 W 49TH ST",
            "address_2": "308",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330123402",
            "telephone_number": "305-827-9140",
            "fax_number": "305-827-9143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 W 49TH ST",
            "address_2": "308",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330123402",
            "telephone_number": "305-827-9140",
            "fax_number": "305-827-9143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRUDENTIAL DIAGNOSTIC CENTER CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-25",
        "last_updated": "2009-04-29",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-827-9140",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "FL",
            "license": "HCC7306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.