Contract Details
Ancillary Care Services
Facility name
South Miami Imaging Center
Provider ID
P000005869
Tax ID
223826279
Effective Date
4/1/2012
Last Updated
9/30/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
84.00
Location Details
Address
7800 Southwest 87th Avenue Suite 110-A
Miami, FL 33173
United States
County
Miami-Dade
Phone
3055959290 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address