Provider Demographics
NPI:1609752419
Name:SERENE DIAGNOSTIC IMAGING DORAL LLC
Entity type:Organization
Organization Name:SERENE DIAGNOSTIC IMAGING DORAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:
Authorized Official - Last Name:MEJIA
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:786-299-1439
Mailing Address - Street 1:2000 NW 87TH AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33172-2656
Mailing Address - Country:US
Mailing Address - Phone:786-299-1439
Mailing Address - Fax:305-845-4549
Practice Address - Street 1:2000 NW 87TH AVE STE 205
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-2656
Practice Address - Country:US
Practice Address - Phone:786-299-1439
Practice Address - Fax:305-845-4549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-15
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology