Healthcare Provider Details

I. General information

NPI: 1982925269
Provider Name (Legal Business Name): MRI ASSOCIATES OF LAKELAND, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2010
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2946 LAKELAND HIGHLANDS RD
LAKELAND FL
33803-4379
US

IV. Provider business mailing address

2946 LAKELAND HIGHLANDS RD UNIT 12
LAKELAND FL
33803-4379
US

V. Phone/Fax

Practice location:
  • Phone: 863-510-5944
  • Fax: 863-510-5939
Mailing address:
  • Phone: 863-510-5944
  • Fax: 863-510-5939

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License NumberHCC8851
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: AMANDA MAPLE
Title or Position: CAO
Credential:
Phone: 727-787-6900