Provider Demographics
NPI:1386754000
Name:ARIZA QUALITY MEDICAL SERVICES,INC
Entity type:Organization
Organization Name:ARIZA QUALITY MEDICAL SERVICES,INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KATIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARIZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-485-9558
Mailing Address - Street 1:11401 SW 40TH ST STE 270
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-3348
Mailing Address - Country:US
Mailing Address - Phone:305-485-9558
Mailing Address - Fax:305-551-6696
Practice Address - Street 1:11401 SW 40TH ST STE 270
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-3348
Practice Address - Country:US
Practice Address - Phone:786-488-2779
Practice Address - Fax:305-551-6696
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHHA299991906251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHHA299991906OtherSTATE LICENSE
FL10D1029620OtherCLIA
FL651079500Medicaid
FL800019519OtherCLINICAL LABORATORY