Contract Details
Ancillary Care Services
Facility name
Gables Diagnostic Center
Provider ID
P000005519
NPI
1871739102
Tax ID
943457985
Effective Date
4/1/2012
Last Updated
10/9/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
5450 Southwest 8th Street Suite 202
Miami, FL 33134
United States
County
Miami-Dade
Phone
3057749001 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address