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General NPI Number Information
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NPI Number | 1740256494
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Entity Type | Organization
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Legal Business Name | FLORIDA RADIOLOGY IMAGING AT LAKE MARY, LLC
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Dates
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Enumeration Date | 02/23/2006
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Last Update Date | 11/08/2024
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Provider Practice Location Address
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Address Line | 960 RINEHART RD STE 1000
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City | LAKE MARY
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State | FL
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Zip | 32746-1561
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Country | US
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Telephone | 855-241-2455
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Fax |
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Provider Business Mailing Address
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Address Line | 900 HOPE WAY
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-1502
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Country | US
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Telephone | 407-200-2355
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Fax | 407-767-0608
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Authorized Official
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Title or Position | COO/VP
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Name | RACHNA ATWAL
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Credential |
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Telephone | 407-200-4658
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085B0100X
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Taxonomy Name | Body Imaging Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2085N0904X
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Taxonomy Name | Nuclear Radiology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2085P0229X
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Taxonomy Name | Pediatric Radiology Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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