Provider Demographics
NPI:1528071438
Name:CT IMAGING INC
Entity type:Organization
Organization Name:CT IMAGING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:M
Authorized Official - Last Name:PENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-887-7562
Mailing Address - Street 1:395 W 10TH ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-3810
Mailing Address - Country:US
Mailing Address - Phone:305-887-7562
Mailing Address - Fax:786-260-0974
Practice Address - Street 1:395 W 10TH ST
Practice Address - Street 2:SUITE 2
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-3810
Practice Address - Country:US
Practice Address - Phone:305-887-7562
Practice Address - Fax:786-260-0974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL56102085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL371319900Medicaid
FL371319900Medicaid