Provider Demographics
NPI:1184694085
Name:VIRTUAL IMAGING SERVICES, INC
Entity type:Organization
Organization Name:VIRTUAL IMAGING SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:F
Authorized Official - Last Name:PUIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-596-9992
Mailing Address - Street 1:7101 SW 99TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-4661
Mailing Address - Country:US
Mailing Address - Phone:305-596-9992
Mailing Address - Fax:305-596-0942
Practice Address - Street 1:7101 SW 99TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-4661
Practice Address - Country:US
Practice Address - Phone:305-596-9992
Practice Address - Fax:305-596-0942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-24
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC3865261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU0551Medicare ID - Type UnspecifiedMEDICARE PROVIDER #