Provider Demographics
NPI:1174600076
Name:P & V MEDICAL DIAGNOSTIC INC
Entity type:Organization
Organization Name:P & V MEDICAL DIAGNOSTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GISELA
Authorized Official - Middle Name:
Authorized Official - Last Name:VALCARCEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-710-8702
Mailing Address - Street 1:14833 SW 80TH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-1541
Mailing Address - Country:US
Mailing Address - Phone:305-710-8702
Mailing Address - Fax:305-380-7846
Practice Address - Street 1:14833 SW 80TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33193-1541
Practice Address - Country:US
Practice Address - Phone:305-710-8702
Practice Address - Fax:305-380-7846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE1809Medicare PIN