Provider Demographics
NPI:1992751812
Name:ADVANCED IMAGING SERVICES INC
Entity type:Organization
Organization Name:ADVANCED IMAGING SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALFREDO
Authorized Official - Middle Name:
Authorized Official - Last Name:PINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-639-0940
Mailing Address - Street 1:1840 W 49TH ST
Mailing Address - Street 2:SUITE 716
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-2942
Mailing Address - Country:US
Mailing Address - Phone:786-639-0940
Mailing Address - Fax:305-863-3347
Practice Address - Street 1:1840 W 49TH ST
Practice Address - Street 2:SUITE 716
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-2942
Practice Address - Country:US
Practice Address - Phone:786-639-0940
Practice Address - Fax:305-863-3347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME32942207RC0000X
FLME592262085R0202X
FL342752471S1302X
FL362732471S1302X
FL593922471V0105X
FL424832471V0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Not Answered2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Not Answered2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonographyGroup - Single Specialty
Not Answered2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular SonographyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU0907Medicare ID - Type UnspecifiedMEDICARE PROVIDER NO