CENTRAL FLORIDA IMAGING OF LEESBURG, LLC (NPI# 1982162681) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982162681 |
| Entity Type | Organization |
| Organization Name | CENTRAL FLORIDA IMAGING OF LEESBURG, LLC |
| Practice Address |
106 W North Blvd Ste 104 Leesburg FL 34748-5039 |
| Mailing Address |
425 Alexandria Blvd Ste 1000 Oviedo FL 32765-5548 |
| Practice Telephone | 3213186758 |
| Mailing Telephone | 4079773434 |
| Enumeration Date | 2019-03-12 |
| Last Update Date | 2019-08-12 |
| Authorized Official Name | MARC OTT (CEO) |
| Authorized Official Telephone | 3527024275 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| Street Address |
106 W NORTH BLVD STE 104 |
| City | LEESBURG |
| State | FL |
| Zip Code | 34748-5039 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437610243 | Ashley Shamsa Martin | Behavior Technician | 292 Bent Oak Ct, Leesburg, FL 34748 | 2019-03-26 |
| 1891278875 | Luis O Aponte Mendoza | Physician Assistant | 704 Doctors Ct., Suite 101, Leesburg, FL 34748 | 2018-09-14 |
| 1881197903 | Physician Associates LLC | Internal Medicine | 22316 Us Highway 27, Leesburg, FL 34748 | 2018-03-15 |
| 1184136145 | Infinite Support Services LLC | In Home Supportive Care | 129 Grove Ridge Circle, 104, Leesburg, FL 34748 | 2017-10-31 |
| 1619403037 | Massage and Wellness Care | Health Maintenance Organization | 1218 W. Dixie Ave, Suite A, Leesburg, FL 34748 | 2017-05-04 |
| 1497202675 | Prime Radiology of Leesburg Inc | Radiology | 600 N W Blvd, Suite E, Leesburg, FL 34748 | 2016-09-06 |
| 1023480332 | Juanita Elizabeth Simpson | Contractor | 1911 Harcourt Drive, Leesburg, FL 34748 | 2015-10-26 |
| 1467835900 | Serenity Choice Place, LLC | Community/Behavioral Health | 721 Balmoral Circle, Leesburg, FL 34748 | 2015-07-01 |
| 1356738397 | Touching Heart's Group Homes, LLC | Community/Behavioral Health | 31809 Sunpark Cir, Leesburg, FL 34748 | 2015-04-16 |
| 1386035269 | Adventist Health System/sunbelt, Inc. | Clinic/Center | 1103 N 14th Street, Leesburg, FL 34748 | 2015-02-12 |
| Find all providers in zip 34748 | ||||
| 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 |
|---|---|---|---|---|
| 1497202675 | Prime Radiology of Leesburg Inc | Radiology | 600 N W Blvd, Suite E, Leesburg, FL 34748 | 2016-09-06 |
| 1629002621 | David Michael Mellman | Radiology | 734 N. 3rd Street Suite 115, Leesburg, FL 34748 | 2006-07-10 |
| 1518940147 | David Lee Factor | Radiology | 801 E Dixie Ave Ste 104, Leesburg, FL 34748-7601 | 2005-11-29 |
| 1841281557 | Charles L Domson II | Radiology | 212 N 2nd St, Leesburg, FL 34748-5103 | 2005-11-02 |
| 1427057603 | Keith E Rockey | Radiology | 4110 E Forest Glen Ave, Leesburg, IN 46538-9552 | 2005-07-19 |
| 1689236275 | Radiology Imaging Specialists LLC | Radiology | 616 N Palmetto St, Leesburg, FL 34748-4417 | 2019-07-03 |
| 1104219948 | Professional Radiology Associates | Radiology | 212 N 2nd St, Leesburg, FL 34748-5103 | 2015-03-17 |
| 1043500937 | Brittany Kristen Nagy | Radiology | 801 E Dixie Ave Ste 104, Leesburg, FL 34748 | 2011-04-12 |
| 1962688366 | Christopher J Schaeffer | Radiology | 801 E Dixie Ave Ste 104, Leesburg, FL 34748 | 2008-01-15 |
| 1639380322 | Epic Teleradiology LLC | Radiology | 26540 Ace Ave, Suite A, Leesburg, FL 34748-8279 | 2007-05-24 |
| Find all providers in LEESBURG | ||||
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| 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.