OPEN MRI OF ORLANDO INC (NPI# 1467491993) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467491993 |
| Entity Type | Organization |
| Organization Name | OPEN MRI OF ORLANDO INC |
| Other Organization Name | LAKESIDE OPEN MRI OF TAVARES |
| Practice Address |
1879 Nightingale Ln Suite A-1 Tavares FL 32778-4363 |
| Practice Telephone | 3527429211 |
| Practice Fax Number | 3527429406 |
| Mailing Telephone | 3527429211 |
| Mailing Fax Number | 3527429406 |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | SHAUN P WOODBURN (PRESIDENT) |
| Authorized Official Telephone | 3527429211 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0200X |
Clinic/Center Specialization: Radiology |
HCC5152 | FL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BLUE CROSS AND BLUE SHEIL | V2544 | 01 |
| Other Name | Type Code |
|---|---|
| Lakeside Open MRI of Tavares | Doing Business As Name - Organization |
| Street Address |
1879 NIGHTINGALE LN SUITE A-1 |
| City | TAVARES |
| State | FL |
| Zip Code | 32778-4363 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588661664 | Borys A Mascarenhas | Surgery | 1879 Nightingale Ln, Ste B4, Tavares, FL 32778-4363 | 2005-07-05 |
| 1285961219 | Andrea Campbell | Nurse Practitioner | 1879 Nightingale Ln, Suite C-1, Tavares, FL 32778-4363 | 2009-11-12 |
| 1225168701 | Keller & Goodman Md, Pa | Internal Medicine | 1879 Nightingale Ln, Suite C-2, Tavares, FL 32778-4363 | 2007-03-06 |
| 1376612358 | Theresa Ann Mills | Emergency Medicine | 1879 Nightingale Ln, Suite C-1, Tavares, FL 32778-4363 | 2006-11-06 |
| 1790881654 | Plastic Surgery Center of Lake County, P.a. | Plastic Surgery | 1879 Nightingale Ln, Suite #a-2, Tavares, FL 32778-4363 | 2006-09-16 |
| 1144330119 | Adina Mariana Ion | Internal Medicine | 1879 Nightingale Ln, Suite C-1, Tavares, FL 32778-4363 | 2006-08-30 |
| 1942235783 | Richard T Bosshardt | Plastic Surgery | 1879 Nightingale Ln, A-2, Tavares, FL 32778-4363 | 2006-07-11 |
| 1336171388 | Peter A. Marzek | Plastic Surgery | 1879 Nightingale Ln, A-2, Tavares, FL 32778-4363 | 2006-07-07 |
| 1821027517 | Julio Henry Lesmes | Internal Medicine | 1879 Nightingale Ln, Ste C-1, Tavares, FL 32778 | 2006-07-03 |
| 1073543310 | Plastic Surgery Center of Lake County | Clinic/Center | 1879 Nightingale Ln, A-2, Tavares, FL 32778-4363 | 2006-07-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487173753 | Erica Denise Irvin | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4681 Marsh Harbor Dr, Tavares, FL 32778 | 2017-09-18 |
| 1922522499 | J&t Divine Care | Home Health | 1554 Auburn Hills Ct, Tavares, FL 32778 | 2017-07-27 |
| 1841738721 | Kelli Maragh | Behavior Technician | 12237 Tavares Ridge Circle, Tavares, FL 32778 | 2017-02-10 |
| 1831633692 | Amanda Williams Sellers | Nurse Practitioner | 1858 Mayo Dr, Tavares, FL 32778 | 2016-12-13 |
| 1235680042 | Natalie Roaine Ash-maheux | Occupational Therapist | 4501 Waterman Way, Tavares, FL 32778 | 2016-10-17 |
| 1396295713 | Sumiko Burley- Collins | Community Health Worker | 1572 Auburn Hills Court, Tavares, FL 32778 | 2016-10-10 |
| 1295100980 | Sunshine Therapy Group, Pa | Speech-Language Pathologist | 2050 Classique Lane, Tavares, FL 32778 | 2015-12-06 |
| 1093188385 | Jana Michelle England | Counselor | 1300 Duncan, Tavares, FL 32778 | 2015-11-09 |
| 1467865980 | Reshma Balmick | Hearing Instrument Specialist | 500 West Burleigh Blvd., Tavares, FL 32778 | 2014-06-03 |
| 1861825739 | Shelagh Kathryn Wood-gouveia | Nurse Practitioner | 1390 East Burleigh Blvd., Tavares, FL 32778 | 2013-08-15 |
| Find all providers in zip 32778 | ||||
| Taxonomy Code | 261QR0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972140028 | Serene Diagnostic Imaging Corp | Clinic/Center | 1751 David Walker Dr, Tavares, FL 32778-5745 | 2019-12-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467053223 | Sheridan-pines Mri, LLC | Clinic/Center | 19442 Sheridan Street, Pembroke Pines, FL 33332 | 2020-11-06 |
| 1114535762 | Coral Hills Imaging LLC | Clinic/Center | 9690 W Sample Rd Ste 103, Coral Springs, FL 33065-4031 | 2020-07-20 |
| 1659990364 | Provectus Health LLC | Clinic/Center | 3972 Durksly Dr, Melbourne, FL 32940-1286 | 2020-04-13 |
| 1619500881 | Adventhealth West Florida Imaging, Inc. | Clinic/Center | 305 E Brandon Blvd Ste B, Brandon, FL 33511-5222 | 2020-02-17 |
| 1831736768 | Bria Group Inc | Clinic/Center | 880 Nw 13th St Ste 100, Boca Raton, FL 33486-2342 | 2019-12-10 |
| 1235770686 | Clermont Radiology LLC | Clinic/Center | 18 Ne 1st Ave, Ocala, FL 34470-6658 | 2019-10-07 |
| 1609422146 | Dis of Tampa Bay Inc | Clinic/Center | 3635 W Waters Ave, Tampa, FL 33614-2783 | 2019-08-12 |
| 1245891209 | Ohri, LLC | Clinic/Center | 392 Rinehart Rd., Suite 1300, Lake Mary, FL 32746 | 2019-06-21 |
| 1417518481 | Ohri, LLC | Clinic/Center | 5151 Winter Garden Vineland Road., Suite 104, Windermere, FL 34786 | 2019-06-21 |
| 1093273971 | Alfa Diagnostic LLC | Clinic/Center | 21355 E Dixie Hwy Ste 107, Aventura, FL 33180-1239 | 2019-03-09 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on OPEN MRI OF ORLANDO 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.