Doctor Name: | MS. ALDYTH IRMA ROACH |
NPI Number: | 1083029771 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 120957 |
Business Practice Address: | 12605 Ne 7th Ave North Miami, FL - 331614813 |
Business Phone Number: | 3058939883 |
Business Fax Number: | 3058935352 |
Mailing Address: | 12605 Ne 7th Ave, NORTH MIAMI |
State: | FL |
Postal Code: | 331614813 |
Phone Number: | 3058939883 |
Fax Number: | 3058935352 |
NPI Enumeration Date: | 06/22/2014 |
NPI Last Update Date: | 06/22/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2471S1302X |
License Number: | 120957 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
Taxonomy Classification: | Radiologic Technologist |
Taxonomy Specialization: | Sonography |
Taxonomy Definition: |