Contract Details
Ancillary Care Services
Facility name
Sunset Radiology
Provider ID
P000003810
NPI
1093863193
Tax ID
200370302
Effective Date
4/1/2012
Last Updated
9/30/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
7000 Southwest 97th Avenue Suite 117
Miami, FL 33173
United States
County
Miami-Dade
Phone
3052736602 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address