Provider Demographics
NPI:1427161256
Name:ADVANCED 3-D DIAGNOSTICS INC
Entity type:Organization
Organization Name:ADVANCED 3-D DIAGNOSTICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:D
Authorized Official - Last Name:DILONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-770-0039
Mailing Address - Street 1:930 S ORANGE AVENUE
Mailing Address - Street 2:STE:1
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806
Mailing Address - Country:US
Mailing Address - Phone:407-770-0039
Mailing Address - Fax:407-447-7509
Practice Address - Street 1:930 S ORANGE AVENUE
Practice Address - Street 2:STE:1
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806
Practice Address - Country:US
Practice Address - Phone:407-770-0039
Practice Address - Fax:407-447-7509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLP04000140182261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP04000140182OtherP04000140182