FLORIDA RADIOLOGY IMAGING AT LAKE MARY LLC (NPI# 1003983610) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003983610 |
| Entity Type | Organization |
| Organization Name | FLORIDA RADIOLOGY IMAGING AT LAKE MARY LLC |
| Other Organization Name | FLORIDA RADIOLOGY IMAGING AT UNIVERSAL CENTER |
| Practice Address |
6000 Turkey Lake Rd Suite 107 Orlando FL 32819-4200 |
| Mailing Address |
Po Box 150130 Altamonte Springs FL 32715-0130 |
| Practice Telephone | 4078348722 |
| Practice Fax Number | 4078345325 |
| Mailing Telephone | 4077675028 |
| Mailing Fax Number | 4077678443 |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2008-02-25 |
| Authorized Official Name | BRIAN REEVES (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 4078348722 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | Y |
| Parent Organization Name | FLORIDA RADIOLOGY IMAGING AT LAKE MARY LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085N0700X |
Radiology Specialization: Neuroradiology |
Allopathic & Osteopathic Physicians | ||
| N | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
Allopathic & Osteopathic Physicians | ||
| N | 2085U0001X |
Radiology Specialization: Diagnostic Ultrasound |
Allopathic & Osteopathic Physicians | ||
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BCBS GROUP NUMBER | V3162 | 01 |
| Other Name | Type Code |
|---|---|
| Florida Radiology Imaging at Universal Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285243394 | Florida Radiology Imaging At Lake Mary LLC | Radiology | 2488 E Irlo Bronson Memorial Hwy, Kissimmee, FL 34744-4948 | 2020-07-24 |
| 1912463258 | Florida Radiology Imaging At Lake Mary LLC | Radiology | 2200 Fowler Grove Blvd Ste 60, Winter Garden, FL 34787-5597 | 2019-02-12 |
| 1851414023 | Florida Radiology Imaging At Lake Mary LLC | Radiology | 12301 Lake Underhill Road, Suite 103, Orlando, FL 32828 | 2007-04-10 |
| 1891874699 | Florida Radiology Imaging At Lake Mary LLC | Radiology | 8000 Red Bug Lake Rd, Suite 120, Oviedo, FL 32765-9226 | 2006-11-03 |
| 1942389747 | Florida Radiology Imaging At Lake Mary LLC | Radiology | 235 E Princeton St, Suite 100, Orlando, FL 32804-5553 | 2006-11-03 |
| Street Address |
6000 TURKEY LAKE RD SUITE 107 |
| City | ORLANDO |
| State | FL |
| Zip Code | 32819-4200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629037452 | Select Physical Therapy Holdings Inc | Clinic/Center | 6000 Turkey Lake Rd, Ste 203, Orlando, FL 32819 | 2006-03-21 |
| 1356961270 | Holly Bottura | Occupational Therapist | 6000 Turkey Lake Rd, Orlando, FL 32819-4200 | 2020-04-21 |
| 1912548751 | Stephanie Levine | Nurse Practitioner | 6000 Turkey Lake Rd, Orlando, FL 32819-4200 | 2019-10-02 |
| 1982196150 | Vanessa Lynn Chevere | Occupational Therapy Assistant | 6000 Turkey Lake Rd, Orlando, FL 32819-4200 | 2018-06-04 |
| 1679062525 | Alison Bongo | Speech-Language Pathologist | 6000 Turkey Lake Rd, Orlando, FL 32819-4200 | 2018-05-07 |
| 1619485562 | Shanita Venise Tyson | Occupational Therapist | 6000 Turkey Lake Rd, Orlando, FL 32819-4200 | 2018-01-12 |
| 1255852935 | Anna-liisa Dehner | Occupational Therapist | 6000 Turkey Lake Rd, Suite 114, Orlando, FL 32819-4205 | 2017-07-03 |
| 1487187266 | Karl Gregory Kurtz | Occupational Therapist | 6000 Turkey Lake Rd, #114, Orlando, FL 32819-4200 | 2017-04-07 |
| 1821520693 | Florida Concierge Dental Care, P.a. | Clinic/Center | 6000 Turkey Lake Rd, #109, Orlando, FL 32819-4200 | 2017-03-31 |
| 1023559119 | Danielle Sanders | Occupational Therapy Assistant | 6000 Turkey Lake Rd, #114, Orlando, FL 32819-4200 | 2017-03-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093356842 | Crew Community Health, Inc | Internal Medicine | 8601 Commodity Circle, Orlando, FL 32819 | 2019-10-03 |
| 1437704756 | Byron Martin Randolph | Physical Therapist | 7932 Sand Lake Rd Ste 203, Orlando, FL 32819 | 2019-08-04 |
| 1225536303 | Alliance Dme LLC | Durable Medical Equipment & Medical Supplies | 7031 Grand National Dr Ste 106b, Orlando, FL 32819 | 2018-01-24 |
| 1417465584 | Marckenson Gerson Janvier | Nurse Practitioner | 9401 Turkey Lake Rd, Orlando, FL 32819 | 2018-01-11 |
| 1871003442 | Sabeen Hasni | Pharmacist | 2354 Commerce Park Drive Ste 100, Orlando, FL 32819 | 2017-10-09 |
| 1902343775 | Darleen Walker | Occupational Therapist | 7243 Della Dr., Orlando, FL 32819 | 2017-01-31 |
| 1215483565 | Krista Richardson | Physical Therapist | 9102 Universal Blvd., Orlando, FL 32819 | 2016-08-28 |
| 1841646536 | Kiara Serrano | Social Worker | 7509 Pinemount Dr, Orlando, FL 32819 | 2016-05-11 |
| 1659749752 | Angels for Kids On-call | Case Management | 7550 Future Drive Suite 105, Orlando, FL 32819 | 2015-09-04 |
| 1932589462 | Krista Jean Cain | Counselor | 7758 Wallace Rd Ste Vi, Orlando, FL 32819 | 2015-05-29 |
| Find all providers in zip 32819 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790301661 | Clearview Diagnostic | Radiology | 8076 S Orange Blossom Trl, Orlando, FL 32809-7670 | 2020-06-17 |
| 1598201998 | Prime Radiology of Pine Hills, Inc | Radiology | 828 Mercy Drive, Suite 4, Orlando, FL 32808 | 2017-01-10 |
| 1366829707 | Florida United Radiology, Lc | Radiology | 8732 Fernwicke Ct, Orlando, FL 32819-3830 | 2015-05-06 |
| 1326440926 | Pedro Miguel Soler Sr. | Radiology | 3310 Northglen Dr, Orlando, FL 32806-6339 | 2014-09-25 |
| 1881000149 | Shalin Mahesh Soni | Radiology | 601 E Rollins St Ste 400, Orlando, FL 32803-1248 | 2014-07-08 |
| 1770843179 | Charles William George | Radiology | 3519 Cullen Lakeshore Drive, Orlando, FL 32812 | 2012-05-21 |
| 1972860831 | Hsiang-jer Tseng | Radiology | 601 E Rollins St Ste 470a, Orlando, FL 32803 | 2012-04-17 |
| 1134390743 | Amir Paydar | Radiology | 2650 Dade Ave, Apt 1422, Orlando, FL 32804-4607 | 2008-03-23 |
| 1649452517 | Unitedrads, LLC | Radiology | 11253 S Apopka Vineland Rd, Orlando, FL 32836 | 2007-12-03 |
| 1225189897 | Robert Marshall | Radiology | 51 W Kaley St, Orlando, FL 32806-2942 | 2007-01-12 |
| Find all providers in ORLANDO | ||||
Please comment or provide details below to improve the information on FLORIDA RADIOLOGY IMAGING AT LAKE MARY LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.