Promed Imaging, LLC

Primary specialty

Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X

Legal business name

PROMED IMAGING, LLC

Practice address

15495 Eagle Nest LN Ste 130
Miami Lakes, FL 33014-2242

Phone

(305) 901-7199

NPI assigned

Feb 7, 2020

Organization subpart

No

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

Authorized official

Name

Trevor Felicetti

Title

Owner

Phone

(561) 210-7669

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1581033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692921600000",
    "number": "1558993501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15495 EAGLE NEST LN STE 130",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15495 EAGLE NEST LN STE 130",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142242",
            "telephone_number": "305-901-7199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMED IMAGING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-07",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A",
        "authorized_official_last_name": "FELICETTI",
        "authorized_official_first_name": "TREVOR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-210-7669"
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCA",
            "identifier": "HCC12062",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "trevor@promedimg.com",
            "affiliation": "N",
            "address_1": "15495 Eagle Nest Ln Ste 130",
            "city": "Miami Lakes",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330142242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Magnetic Resonance Imaging (MRI) Clinic/Center in Miami Lakes, FL
• Providers in Miami Lakes, FL by specialty
• Magnetic Resonance Imaging (MRI) Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2023; 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.