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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
1U5LGOOTHERFLBCBS FL

General Provider Information

NPI Number : 1326404195
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 : 130 PABLO ST
Second Line :
City : LAKELAND
State : FL
Zip : 33803-3818
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 : 01/11/2016
Last Update Date : 03/03/2026

Similar Medicare Providers

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Practice Location Address:
130 PABLO ST
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1982600417 — RAUL TALLO M.D.
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1790781219 — RAUL A LOPEZ M.D.
Practice Location Address:
130 PABLO ST
LAKELAND, FL
33803-3818
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1154327674 — PHILIP SELWYN OWEN M.D.
Practice Location Address:
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1619962289 — DEBRA L. SEOANE M.D.
Practice Location Address:
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Directions to “RADIOLOGY & IMAGING SPECIALISTS OF LAKELAND, PA ” Practice Location

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