Lake Medical Imaging and Breast Center at the Villages LLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

LAKE MEDICAL IMAGING AND BREAST CENTER AT THE VILLAGES LLC

Practice address

1400 N US Highway 441 Ste 510
The Villages, FL 32159-8983

Phone

(352) 787-5858

Fax

(352) 787-4655

NPI assigned

Jun 22, 2021

Organization subpart

No

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

Authorized official

Name

Joshua Lee Floyd, PHD

Title

Director, Risk Management

Phone

(365) 352-2583

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Lake Medical Imaging and Breast Center at the Villages LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

• Lake Medical Imaging and Breast Center at the Villages LLC

  • Diagnostic Radiology Physician
  • The Villages, FL
  • NPI 1366015232
  NPD tax ID
• Lake Medical Imaging and Breast Center at the Villages LLC

  • Diagnostic Radiology Physician
  • The Villages, FL
  • NPI 1659940807
  NPD tax ID
• Lake Medical Imaging and Breast Center at the Villages LLC

  • Diagnostic Radiology Physician
  • The Villages, FL
  • NPI 1912570045
  NPD tax ID
• Lake Medical Imaging and Breast Center at the Villages LLC

  • Diagnostic Radiology Physician
  • The Villages, FL
  • NPI 1942879192
  NPD tax ID

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

{
    "created_epoch": "1624320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624406400000",
    "number": "1104495324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "734 N 3RD ST STE 115",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347485287",
            "telephone_number": "352-365-2583",
            "fax_number": "352-728-6749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N US HIGHWAY 441 STE 510",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321598983",
            "telephone_number": "352-787-5858",
            "fax_number": "352-787-4655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE MEDICAL IMAGING AND BREAST CENTER AT THE VILLAGES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-22",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A",
        "authorized_official_last_name": "FLOYD",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "DIRECTOR, RISK MANAGEMENT",
        "authorized_official_telephone_number": "365-352-2583",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101183200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Arlyn Jennifer Kvares, OT
• Nancy L La Pierre, LPC, LMHC
• Laboratory Corporation of America
• Brett Labossiere
• Kiran Babu Lachireddy, PA
• Lake Medical Imaging and Breast Center at the Villages LLC
• Lake Medical Imaging and Breast Center at the Villages LLC
• Lake Medical Imaging and Breast Center at the Villages LLC
• Lake Medical Imaging and Breast Center at the Villages LLC
• Lake Point Medical Associates Inc

• Diagnostic Radiology Physician in The Villages, FL
• Providers in The Villages, FL by specialty
• Diagnostic Radiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.