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Street Address

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974 SW 82ND AVE
MIAMI, FL 33144-4271
Phone: (305) 267-6145
County: Miami-Dade

Mailing Address

974 SW 82ND AVE
MIAMI, FL 33144-4271
County: Miami-Dade

Emergency Actions:

None
Facility/Provider Type: Health Care Clinic
Medical or Clinic Director: MIRIAM MERCEDES LARA MD
Financial Officer: SERGIO JULIAN ORTEGA
Owner/Licensee: FLORIDA MOBILE IMAGING SERVICES, INC
Owner/Licensee Since: 9/10/2007
NamePositionOwnership
SERGIO JULIAN ORTEGA 100%
Profit Status: For-Profit
Licensed Beds: Not Available
AHCA Number (File Number): 8160
AHCA Field Office: 11
License Number: 7910
Current License Effective: 11/19/2015
Expires: 11/18/2017
License Status: IN REVIEW

Services/Characteristics:

Type :  Portable Equipment Provider

Legal Actions

Date ImposedCase #Case TypeViolationFine Amount
02/19/2010 2009014064 FineApplication $500.00
Please note the legal actions above may have been issued to a prior owner. The Final Order displays the name of the licensee responsible for the legal action that was taken.


Attn Providers: Requests for changes in data must be sent in writing to the AHCA licensing office.
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