FLORIDA RADIOLOGY IMAGING AT LAKE MARY LLC NPI 1003208620

NPI Information

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:

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