Baycare Outpatient Imaging LLC
Organization Active NPI Diagnostic Radiology Physician · Tampa, FL
NPI 1740153006 · NPPES record last updated Sep 24, 2025
Key facts
- NPI
- 1740153006
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- Legal business name
- BAYCARE OUTPATIENT IMAGING LLC
- Practice address
- 11802 N Dale Mabry Hwy Ste 201
Tampa, FL 33618-3506 - Phone
- (813) 425-0515
- NPI assigned
- Sep 24, 2025
- Organization subpart
- No
Authorized official
- Name
- Lynda Gorken
- Title
- Vice President
- Phone
- (727) 281-9202
Other NPIs on the same Medicare enrollment 6
Corporate family (same tax ID) 8
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D2340060 | Baycare Outpatient Imaging, LLC | Certificate of waiver | Mar 10, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190410002311 | FL | Part B Supplier - Clinic/Group Practice | 3577804087 |
Receives reassigned benefits from 177 practitioners 6 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Wesley Chapel, FL; Winter Haven, FL; Valrico, FL; Tampa, FL; Plant City, FL; Land O Lakes, FL |
National Provider Directory
- Tax ID family
- Baycare Outpatient Imaging LLC
Locations
11802 N Dale Mabry Hwy
Ste 201
Tampa, FL 33618
Phone (813) 425-0515
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician |
2085R0202X | Yes |
Addresses
Primary practice location
11802 N Dale Mabry Hwy Ste 201
Tampa, FL 33618-3506
Mailing address
2995 Drew St FL 2
Clearwater, FL 33759-3012
Phone (727) 315-6974
Other providers in Tampa, FL
- Baycare Medical Group Inc
- Baycare Medical Group Pediatric Walk-in, LLC
- Baycare Medical Group, Inc
- Baycare Occupational Health
- Baycare Outpatient Imaging LLC
- Baycare Urgent Care, LLC
- Baycare Urgent Care, LLC
- Baycare Urgent Care, LLC
- Baycare Urgent Care, LLC
- Baycare Urgent Care, LLC
All providers in Tampa, FL · Diagnostic Radiology Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 24, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.