Provider Demographics
NPI:1104164540
Name:JENPI DIAGNOSTIC CENTER CORP
Entity type:Organization
Organization Name:JENPI DIAGNOSTIC CENTER CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PABLO
Authorized Official - Middle Name:
Authorized Official - Last Name:OROZCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-396-3298
Mailing Address - Street 1:1041 NE 40TH RD
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-5929
Mailing Address - Country:US
Mailing Address - Phone:305-396-3298
Mailing Address - Fax:786-999-6425
Practice Address - Street 1:1041 NE 40TH RD
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-5929
Practice Address - Country:US
Practice Address - Phone:305-396-3298
Practice Address - Fax:786-999-6425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-18
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME811812471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonographyGroup - Single Specialty