CLERMONT RADIOLOGY LLC (NPI# 1982619417) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982619417 |
| Entity Type | Organization |
| Organization Name | CLERMONT RADIOLOGY LLC |
| Practice Address |
1804 Oakley Seaver Blvd Suite B Clermont FL 34711-1925 |
| Mailing Address |
2180 Premier Row Orlando FL 32809-6210 |
| Practice Telephone | 3522416100 |
| Practice Fax Number | 3522416101 |
| Mailing Telephone | 3522416100 |
| Mailing Fax Number | 3522419751 |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2010-05-14 |
| Authorized Official Name | ROBERT SERROS JR. (PRESIDENT/CEO) |
| Authorized Official Telephone | 4074387847 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 293D00000X | Physiological Laboratory | HCC6405 | FL | Laboratories |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | AETNA | 7993661 | 01 |
| FL | BC/BS | V3070 | 01 |
| FL | HEALTHEASE | 279750 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235770686 | Clermont Radiology LLC | Clinic/Center | 18 Ne 1st Ave, Ocala, FL 34470-6658 | 2019-10-07 |
| 1003328642 | Clermont Radiology LLC | Clinic/Center | 3725 South Highway 27, Suite 104, Clermont, FL 34711 | 2017-11-03 |
| 1033426622 | Clermont Radiology LLC | Clinic/Center | 871 Oakley Seaver Drive, Clermont, FL 34711 | 2010-09-03 |
| Street Address |
1804 OAKLEY SEAVER BLVD SUITE B |
| City | CLERMONT |
| State | FL |
| Zip Code | 34711-1925 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215901723 | Kidsville Pediatrics IIi, P.a. | Pediatrics | 1804 Oakley Seaver Blvd, Suite-c, Clermont, FL 34711-1925 | 2006-02-14 |
| 1487620993 | Christopher James Johnson | Surgery | 1804 Oakley Seaver Blvd, Suite A, Clermont, FL 34711-1925 | 2006-02-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316546344 | Latricia Richards-smith | Nurse Practitioner | 3301 Hancock Rd, Clermont, FL 34711 | 2020-10-21 |
| 1073130399 | Marissa Johnston | Behavioral Analyst | 355 Citrus Tower Blvd Ste 112, Clermont, FL 34711 | 2020-07-02 |
| 1649839432 | New Foundations Aba Therapy, LLC | Community/Behavioral Health | 4327 S Hwy 27 #176 Clermont, Clermont, FL 34711 | 2019-06-06 |
| 1275006504 | Innovative Medical Management Solutions LLC | Skilled Nursing Facility | 1775 Hooks Street, Clermont, FL 34711 | 2019-01-09 |
| 1851867766 | Chantal P Baptiste | Nurse Practitioner | 2040 Oakley Seaver Dr Ste 300, Clermont, FL 34711 | 2018-10-17 |
| 1346739539 | Jennifer Brennan | Behavior Technician | 365 Citrus Tower Blvd Bldg Ste 106, Clermont, FL 34711 | 2018-05-03 |
| 1689163966 | Chelsea Strickland | Physical Therapy Assistant | 10037 Stockbridge St, Clermont, FL 34711 | 2018-05-02 |
| 1316448921 | Dana Renee Ottalagano | Counselor | 1635 E Highway 50 Ste 204, Clermont, FL 34711 | 2018-02-28 |
| 1306353842 | Center of Change Inc. | General Practice | 235 Citrus Tower Blvd Ste 104, Clermont, FL 34711 | 2018-01-05 |
| 1003328642 | Clermont Radiology LLC | Clinic/Center | 3725 South Highway 27, Suite 104, Clermont, FL 34711 | 2017-11-03 |
| Find all providers in zip 34711 | ||||
| Taxonomy Code | 293D00000X |
| Grouping | Laboratories |
| Classification | Physiological Laboratory |
| A laboratory that operates independently of a hospital and physician’s office to furnish physiological diagnostic services (e.g. EEG’s , EKG’s, scans, etc.). Facilities offering ONLY physiological services are not certified as independent laboratories. If an independent laboratory offers physiological services IN ADDITION to clinical laboratory services, they are surveyed only for compliance with the clinical laboratory regulations because there are no health and safety regulations for physiological services. |
| Notes: Source: Paraphrased from the Medicare Carrier Manual, Section 2070.5. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285240192 | Ohi West Medical Group, LLC | Physiological Laboratory | 2201 Central Ave Ste 100, St Petersburg, FL 33713-8844 | 2020-09-17 |
| 1619446853 | Myvy Southwest Imaging LLC | Physiological Laboratory | 1160 Kane Concourse Ste 402, Bay Harbor Is, FL 33154-2059 | 2018-11-16 |
| 1366919961 | Richard Thomas Escobar | Physiological Laboratory | 2111 S Pine Ave Ste B, Ocala, FL 34471-8194 | 2018-11-01 |
| 1316398787 | Braincare, LLC | Physiological Laboratory | 12301 Lake Underhill Rd Ste 201, Orlando, FL 32828-4511 | 2016-06-28 |
| 1124486931 | R&r Medx Solutions LLC | Physiological Laboratory | 7144 Stirling Rd, Ste 185, Hollywood, FL 33024-1650 | 2016-02-08 |
| 1730568486 | My Diagnostic Team Inc | Physiological Laboratory | 3114 45th St, Suite 9, West Palm Beach, FL 33407-1945 | 2015-05-28 |
| 1508260399 | Douglas Lyons | Physiological Laboratory | 1250 Diana Ave, Naples, FL 34103-4567 | 2014-10-22 |
| 1275956005 | University of South Florida | Physiological Laboratory | 3702 Spectrum Blvd, Suite 165, Tampa, FL 33612-9444 | 2014-01-30 |
| 1891125936 | Portable Medical Diagnostics, Inc | Physiological Laboratory | 8080 Belvedere Rd Ste 6, West Palm Beach, FL 33411-6224 | 2013-11-26 |
| 1083950752 | Beachway Therapy Treatment Center LLC | Physiological Laboratory | 705 Bond Way Ste B, Delray Beach, FL 33483-5826 | 2012-12-27 |
| Find all providers with the same taxonomy | ||||
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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.