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FLORIDA RADIOLOGY IMAGING AT LAKE MARY LLC NPI 1003208620


NPI Information

NPI: 1003208620
Provider Name: FLORIDA RADIOLOGY IMAGING AT LAKE MARY, LLC

Doing Business As: ADVENTHEALTH IMAGING LAKE NONA

Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

CLIA Number: 10D2189253

Address:
9975 TAVISTOCK LAKES BLVD
SUITE 120
ORLANDO, FL
ZIP 32827
Phone: (407) 200-2865
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FLORIDA RADIOLOGY IMAGING AT LAKE MARY, LLC is a diagnostic radiology radiology in Orlando, FL. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. FLORIDA RADIOLOGY IMAGING AT LAKE MARY, LLC NPI is 1003208620. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Adventhealth Imaging Lake Nona.

The provider's business location address is:

9975 TAVISTOCK LAKES BLVD
SUITE 120
ORLANDO, FL
ZIP 32827-559
Phone: (407) 200-2865

The provider's authorized official is Warren Wylie .
The authorized official title is Vp Radiology Enterprise and has the following contact phone number (407) 303-3358.

The CLIA number assigned to this NPI record is 10D2189253 - hospital with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/19/2015 and was last updated on 2/11/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12085R0202XRadiologyDiagnostic RadiologyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/15/2022

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.