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FLORIDA RADIOLOGY IMAGING AT LAKE MARY LLC NPI 1851414023


NPI Information

NPI: 1851414023
Provider Name: FLORIDA RADIOLOGY IMAGING AT LAKE MARY LLC

Doing Business As: FLORIDA RADIOLOGY IMAGING AT WATERFORD LAKES

Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

Address:
12301 LAKE UNDERHILL ROAD
SUITE 103
ORLANDO, FL
ZIP 32828
Phone: (407) 834-8722
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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 1851414023. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Florida Radiology Imaging At Waterford Lakes.

The provider's business location address is:

12301 LAKE UNDERHILL ROAD
SUITE 103
ORLANDO, FL
ZIP 32828
Phone: (407) 834-8722

The provider's authorized official is Pedro Rodriguez .
The authorized official title is Medical Director and has the following contact phone number (407) 949-6444.

The enumeration date for this NPI number is 4/10/2007 and was last updated on 6/20/2019.


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
12085B0100XRadiologyBody ImagingNo
22085N0700XRadiologyNeuroradiologyNo
32085N0904XRadiologyNuclear RadiologyNo
42085R0204XRadiologyVascular & Interventional RadiologyNo
52085U0001XRadiologyDiagnostic UltrasoundNo
62085R0202XRadiologyDiagnostic RadiologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11740256494OTHERFLORIDANPI BASE FOR GROUP
22656442 04MEDICAIDFLORIDA

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: 4/28/2024

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.