Provider Demographics
NPI:1912782350
Name:YEOLI IMAGING LLC
Entity type:Organization
Organization Name:YEOLI IMAGING LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YEINET
Authorized Official - Middle Name:
Authorized Official - Last Name:OLIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:786-332-1585
Mailing Address - Street 1:9900 SW 107TH AVE STE 200B
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2809
Mailing Address - Country:US
Mailing Address - Phone:786-332-1585
Mailing Address - Fax:305-675-0343
Practice Address - Street 1:9900 SW 107TH AVE STE 200B
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2809
Practice Address - Country:US
Practice Address - Phone:786-332-1585
Practice Address - Fax:305-675-0343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-25
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Multi-Specialty
No2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonographyGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No293D00000XLaboratoriesPhysiological Laboratory