LAKE WALES MEDICAL IMAGING CENTER ONE, INC (NPI# 1063657955) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063657955 |
| Entity Type | Organization |
| Organization Name | LAKE WALES MEDICAL IMAGING CENTER ONE, INC |
| Practice Address |
1255 Highway 60 East 110 Lake Wales FL 33853 |
| Mailing Address |
2301 Longleaf Blvd Suite 200 Lake Wales FL 33859 |
| Practice Telephone | 8632325111 |
| Enumeration Date | 2008-12-08 |
| Last Update Date | 2008-12-08 |
| Authorized Official Name | DR. KOLLAGUNTA CHANDRASEKHAR (PRESIDENT) |
| Authorized Official Telephone | 8632325111 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 247000000X | Technician, Health Information | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
1255 HIGHWAY 60 EAST 110 |
| City | LAKE WALES |
| State | FL |
| Zip Code | 33853 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881218998 | Marcel Fundora | Dentist | 701 Fl-60, Lake Wales, FL 33853 | 2020-06-04 |
| 1386291599 | Adventist Health System /sunbelt, Inc. | Clinic/Center | 1255 Florida 60, Suite 300, Lake Wales, FL 33853 | 2019-08-22 |
| 1932753472 | Adeline Brooke Warren | Occupational Therapist | 512 S 11th Street, Lake Wales, FL 33853 | 2019-08-01 |
| 1033563580 | Amber Y Shepard | Family Medicine | 1255 Highway 60 E Ste 500, Lake Wales, FL 33853 | 2016-04-21 |
| 1174982458 | Ledesha Marie Dorothy Maduro | Dentist | 24185 Us Hwy 27 North, Lake Wales, FL 33853 | 2016-02-16 |
| 1528402435 | Buck Andreu Scott | Surgery | 407 S 11th St, Lake Wales, FL 33853 | 2013-04-22 |
| 1447598321 | Central Florida Health Care, Inc. | Dentist | 305 West Central Avenue, Lake Wales, FL 33853 | 2013-01-28 |
| 1972864932 | Kevin T Barlow, Pa. Dba: Winter Haven Audiology and Ridge Audiology. | Clinic/Center | 704 Sr 60 East, Lake Wales, FL 33853 | 2012-06-06 |
| 1316266364 | Elba M Lopez | Massage Therapist | 318 S. First Street, Lake Wales, FL 33853 | 2010-05-28 |
| 1467605634 | Multi-specialty & Primary Care Practice Group of Lake Wales LLC | Specialist | 1255 State Road 60 East, Lake Wales, FL 33853 | 2008-10-31 |
| Find all providers in zip 33853 | ||||
| Taxonomy Code | 247000000X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Technician, Health Information |
| Preferred term for an Accredited Record Technician who is an individual with an associate’s degree from an accredited college or independent study program who is skilled in analyzing health information and in examination of medical records for accuracy, reporting of patient data for reimbursement, and creation of disease registries for researchers. |
| Notes: Source: American Health Information Management Association, Chicago, IL, 1996. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437764594 | Yessica Saez | Technician, Health Information | 11223 Groveview Way, Sanford, FL 32773-5983 | 2020-09-14 |
| 1265041834 | Medical Coding and Billing Specialist | Technician, Health Information | 19920 Nw 32nd Ave, Miami Gardens, FL 33056-1800 | 2020-07-29 |
| 1811555220 | Tanisha Okonji | Technician, Health Information | 3707 Silver Bluff Blvd, Orange Park, FL 32065-4238 | 2019-05-31 |
| 1447747134 | Joseph P Robert | Technician, Health Information | 8471 Nw19th St, Pembroke Pines, FL 33024 | 2018-04-18 |
| 1912400714 | Christopher Deese | Technician, Health Information | 10211 Sw 137th Pl, Miami, FL 33186-7352 | 2018-03-18 |
| 1316462328 | Sarah Carter | Technician, Health Information | 2301 S Ocean Dr Apt 502, Hollywood, FL 33019-2621 | 2017-08-10 |
| 1558890913 | Juliana Andrea Duque | Technician, Health Information | 11301 Nw 29th Street, Sunrise, FL 33323 | 2017-06-08 |
| 1619428471 | Thomas Freeman II | Technician, Health Information | 3815 H C Mccray Jr Dr, Panama City, FL 32401-5613 | 2016-10-17 |
| 1174895304 | Prachi Lustgarten | Technician, Health Information | 1801 Se Coconut Street, Hobe Sound, FL 33455 | 2012-02-03 |
| 1942583000 | Gary Goodworth | Technician, Health Information | 7635 Weston Ct, New Port Richey, FL 34654-6215 | 2011-09-26 |
| Find all providers with the same taxonomy | ||||
| City | LAKE WALES |
| Zip Code | 33853 |
Please comment or provide details below to improve the information on LAKE WALES MEDICAL IMAGING CENTER ONE, INC.
| 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.