Organization Name: | ARQ. ELECTRO DIAGNOSTIC, INC. |
NPI Number: | 1073553319 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ARACELIS C QUEVEDO (PRESIDENT/OWNER) |
Mailing Address: | 8180 Nw 36th St Suite 239 Doral |
State: | FL US |
Postal Code: | 331666645 |
Phone Number: | 3055943038 |
Fax Number: | 3055948575 |
NPI Enumeration Date: | 06/07/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | HCCR745 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |