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NPI Code Detail

MEDICARE: RADIOLOGY & IMAGING SPECIALISTS OF LAKELAND, PA

MEDICARE: RADIOLOGY & IMAGING SPECIALISTS OF LAKELAND, PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1V2699OTHERFLBCBS FL

General Provider Information

NPI Number : 1649543992
Entity Type Code : Organization
Provider Name (Legal Business Name) : RADIOLOGY & IMAGING SPECIALISTS OF LAKELAND, PA
Provider Business Mailing Address
First Line : PO BOX 20027
Second Line :
City : TAMPA
State : FL
Zip : 33622-0027
Country : US
Telephone Number : 800-475-6112
Fax Number : 706-653-1230
Provider Business Practice Location Address
First Line : 1305 LAKELAND HILLS BLVD
Second Line :
City : LAKELAND
State : FL
Zip : 33805-4542
Country : US
Telephone Number : 863-688-2334
Fax Number : 706-653-1230
Authorized Official
Title or Position : CFO
Name : JOHN BARRETT
Credential :
Telephone Number : 863-688-2334
Provider Enumeration Date : 02/17/2012
Last Update Date : 03/03/2026

Similar Medicare Providers

1760484745 — LAKELAND FAMILY MEDICINE
Practice Location Address:
1305 LAKELAND HILLS BLVD , SUITE 101
LAKELAND, FL
33805-4542
Practice Phone: 863-687-9333
Practice Fax: 863-686-0160
1215928882 — DR. MARTIN GEZA RADVANY M.D.
Practice Location Address:
1305 LAKELAND HILLS BLVD
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Practice Fax:
1437140951 — DR. MARTHA LIMA M. D.
Practice Location Address:
1305 LAKELAND HILLS BLVD
LAKELAND, FL
33805-4542
Practice Phone: 863-688-2334
Practice Fax:
1538150933 — DR. BRET D. HENRICKS M. D.
Practice Location Address:
1305 LAKELAND HILLS BLVD
LAKELAND, FL
33805-4542
Practice Phone: 863-688-2334
Practice Fax:
1740271121 — DR. SCOTT A. FARGHER M. D.
Practice Location Address:
1305 LAKELAND HILLS BLVD
LAKELAND, FL
33805-4542
Practice Phone: 863-688-2334
Practice Fax:
1609867084 — DR. THOMAS M. GOODNIGHT M. D.
Practice Location Address:
1305 LAKELAND HILLS BLVD
LAKELAND, FL
33805-4542
Practice Phone: 863-688-2334
Practice Fax:

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