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Organization Active NPI

Florida Radiology Imaging at Lake Mary LLC

Doing business as Florida Radiology Imaging at Universal Center

  • Diagnostic Radiology Physician
  • Orlando, FL
National Provider Identifier
1003983610
Registry record updated Feb 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
FLORIDA RADIOLOGY IMAGING AT LAKE MARY LLC
Doing business as
Florida Radiology Imaging at Universal Center
Practice address
6000 Turkey Lake Rd
Suite 107
Orlando, FL 32819-4200
Phone
(407) 834-8722
Fax
(407) 834-5325
NPI assigned
Nov 29, 2006
Last updated
Feb 25, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
FLORIDA RADIOLOGY IMAGING AT LAKE MARY LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 25, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Brian Reeves, D.O.
Title
Medical Director
Phone
(407) 834-8722

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085N0700X
Diagnostic Radiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085R0202X Primary
Vascular & Interventional Radiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085R0204X
Diagnostic Ultrasound PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085U0001X

Addresses

Primary practice location

6000 Turkey Lake Rd
Suite 107
Orlando, FL 32819-4200

Mailing address

PO Box 150130
Altamonte Springs, FL 32715-0130
Phone (407) 767-5028

Other identifiers 1

IdentifierTypeStateIssuer
V3162OtherFLBCBS GROUP NUMBER

Other names 1

  • Florida Radiology Imaging at Universal Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040721001414 FL Part B Supplier - Clinic/Group Practice 1254311137 Receives reassigned benefits from 420 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Orlando, FL; Oviedo, FL; Palm Beach Gardens, FL; Parkland, FL; Port Orange, FL; Vero Beach, FL; Weston, FL; Wilton Manors, FL…

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Adventhealth Imaging

Locations

1919 E Highway 50
Ste 101
Clermont, FL 34711
Phone (352) 717-3738

2488 E Irlo Bronson Memorial Hwy
Ste 101
Kissimmee, FL 34744

960 Rinehart Rd
Ste 1000
Lake Mary, FL 32746
Phone (855) 241-2455

12301 Lake Underhill Rd
Ste 113
Orlando, FL 32828
Phone (407) 949-6444

235 E Princeton St
Ste 100
Orlando, FL 32804
Phone (407) 303-1414

8000 Red Bug Lake Rd
Ste 120
Oviedo, FL 32765
Phone (407) 977-7460

5821 S Williamson Blvd
Ste 101
Port Orange, FL 32128
Phone (386) 231-2951

2200 Fowler Grove Blvd
Ste 60
Winter Garden, FL 34787
Phone (407) 200-0538

Practitioners & affiliated clinicians

Practitioners 50

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 50

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203897600000",
    "number": "1003983610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 150130",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327150130",
            "telephone_number": "407-767-5028",
            "fax_number": "407-767-8443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 TURKEY LAKE RD",
            "address_2": "SUITE 107",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328194200",
            "telephone_number": "407-834-8722",
            "fax_number": "407-834-5325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA RADIOLOGY IMAGING AT LAKE MARY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FLORIDA RADIOLOGY IMAGING AT LAKE MARY LLC",
        "enumeration_date": "2006-11-29",
        "last_updated": "2008-02-25",
        "status": "A",
        "authorized_official_last_name": "REEVES",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "407-834-8722",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Neuroradiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER",
            "identifier": "V3162",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Florida Radiology Imaging at Universal Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.