Contract Details
Ancillary Care Services
Facility name
Gables Diagnostic Center
Provider ID
P000003947
NPI
1174516637
Tax ID
591771206
Effective Date
4/1/2012
Last Updated
10/1/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
475 Biltmore Way Suite 106
Coral Gables, FL 33134
United States
County
Miami-Dade
Phone
3054611700 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address