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NPI Code Detail

MEDICARE: RADIOLOGY & IMAGING SPECIALISTS OF LAKELAND

MEDICARE: RADIOLOGY & IMAGING SPECIALISTS OF LAKELAND
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

General Provider Information

NPI Number : 1548019698
Entity Type Code : Organization
Provider Name (Legal Business Name) : RADIOLOGY & IMAGING SPECIALISTS OF LAKELAND
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 : 863-688-2334
Provider Business Practice Location Address
First Line : 2400 KATHLEEN RD
Second Line :
City : LAKELAND
State : FL
Zip : 33810-3077
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 : 05/13/2024
Last Update Date : 03/03/2026

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