Idaca LLC

Primary specialty

Mammography Clinic/CenterTaxonomy code 261QR0206X

Legal business name

IDACA LLC

Practice address

49 W 49TH St
Hialeah, FL 33012-3709

Phone

(305) 557-0330

Fax

(305) 556-5133

NPI assigned

Sep 17, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Jose Rangel

Title

Coo

Phone

(305) 557-0330

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1410912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466467200000",
    "number": "1407258833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 W 49TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330123709",
            "telephone_number": "305-557-0330",
            "fax_number": "305-556-5133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 W 49TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330123709",
            "telephone_number": "305-557-0330",
            "fax_number": "305-556-5133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDACA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-17",
        "last_updated": "2016-06-21",
        "status": "A",
        "authorized_official_last_name": "RANGEL",
        "authorized_official_first_name": "JOSE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "305-557-0330",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0206X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mammography",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mammography Clinic/Center in Hialeah, FL
• Providers in Hialeah, FL by specialty
• Mammography Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2016; 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.