Mia Mobil Diagnostic Inc

Primary specialty

SpecialistTaxonomy code 174400000X

License

CRT63103 Issued in FL

Legal business name

MIA MOBIL DIAGNOSTIC INC

Practice address

9807 NW 80TH Ave Unit 11F
Hialeah, FL 33016-2325

Phone

(305) 362-9522

Fax

(305) 362-9471

NPI assigned

May 7, 2007

Organization subpart

No

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

Authorized official

Name

Prof. Daniel R Fundora, CRT

Title

President

Phone

(305) 362-9522

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972716181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 MAJORCA AVE APT 4",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331344603",
            "telephone_number": "305-362-9522",
            "fax_number": "305-362-9471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9807 NW 80TH AVE UNIT 11F",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330162325",
            "telephone_number": "305-362-9522",
            "fax_number": "305-362-9471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIA MOBIL DIAGNOSTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FUNDORA",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-362-9522",
        "authorized_official_name_prefix": "Prof.",
        "authorized_official_credential": "CRT"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "CRT63103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Hialeah, FL
• Providers in Hialeah, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.