OrganizationPrudential Diagnostic Center Corp.Clinic/CenterAmbulatory Health Care FacilitiesPractice Address900 W 49th St, 308, Hialeah, FL 33012-3402(305) 827-9140PECOS EnrollmentBased on the most recent information from CMS, provider Prudential Diagnostic Center Corp. does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1255573002Provider TypeOrganizationFull NamePrudential Diagnostic Center Corp.SubpartNoEnumeration Date3/25/2009Last Updated4/29/2009Contact InformationPractice LocationPractice Address900 W 49th St, 308, Hialeah, FL 33012-3402Phone(305) 827-9140Fax(305) 827-9143Mailing LocationMailing Address900 W 49th St, 308, Hialeah, FL 33012-3402Phone(305) 827-9140Fax(305) 827-9143Authorized OfficialNamePerez, Juan C (President)Phone(305) 827-9140Provider TaxonomiesCodeDescriptionLicenseCode261QH0100XPrimaryDescriptionClinic/CenterAmbulatory Health Care FacilitiesLicenseHCC7306Florida