In His Image Medical, Inc

Primary specialty

Mobile Radiology Clinic/CenterTaxonomy code 261QR0208X

License

00069740 Issued in FL

Legal business name

IN HIS IMAGE MEDICAL, INC

Practice address

13550 SW 88TH St Ste 180
Miami, FL 33186-1513

Phone

(305) 381-2868

NPI assigned

Feb 4, 2009

Organization subpart

No

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

Authorized official

Name

Richard Anthony Bonilla, RCS, CVTNPI 1356660831

Title

Owner/President

Phone

(305) 345-2055

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Richard Bonilla, RCS, CVT

  • Sonography Specialist/Technologist Cardiovascular
  • Miami, FL
  • NPI 1356660831
  NPD (past) Authorized official

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

{
    "created_epoch": "1233705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587427200000",
    "number": "1316186943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16510 SW 96TH TER",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331965832",
            "telephone_number": "305-345-2055",
            "fax_number": "305-388-3182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13550 SW 88TH ST STE 180",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331861513",
            "telephone_number": "305-381-2868"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13550 N Kendall Dr",
            "address_2": "Suite 180",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331861654",
            "country_code": "US",
            "telephone_number": "305-385-9919",
            "fax_number": "786-472-4520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "IN HIS IMAGE MEDICAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-04",
        "last_updated": "2020-04-21",
        "certification_date": "2020-04-21",
        "status": "A",
        "authorized_official_last_name": "BONILLA",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "305-345-2055",
        "authorized_official_credential": "RCS, CVT"
    },
    "taxonomies": [
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": "FL",
            "license": "00069740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mobile Radiology Clinic/Center in Miami, FL
• Providers in Miami, FL by specialty
• Mobile Radiology Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2020; 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.