Sand Lake Imaging LLLP

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

SAND LAKE IMAGING LLLP

Practice address

9350 Turkey Lake Rd
Orlando, FL 32819-7319

Phone

(407) 363-2772

Fax

(407) 745-2844

NPI assigned

Nov 19, 2005

Organization subpart

No

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

Authorized official

Name

Susan C Holman

Title

Sr. Director, RCM

Phone

(866) 674-7933

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Amir Hedayati, M.D.

  • Diagnostic Radiology Physician
  • Sanford, FL
  • NPI 1770534869
  NPD (past)
• Jose Alfonso Pizarro, MD

  • Diagnostic Radiology Physician
  • Windermere, FL
  • NPI 1568458388
  NPD (past)
• Peter Urban, M.D.

  • Ophthalmic Technician/Technologist
  • Perry, FL
  • NPI 1104045103
  NPD (past)
• Diana L Wilson, MD

  • Diagnostic Radiology Physician
  • Ocoee, FL
  • NPI 1790059970
  NPD (past)
• Chanhi Park, M.D.

  • Diagnostic Radiology Physician
  • North Chesterfield, VA
  • NPI 1881677854
  NPD (past)
• Edward H. Sessions, M.D.

  • Diagnostic Radiology Physician
  • Lynnwood, WA
  • NPI 1295718260
  NPD (past)
• Sydney S. Yoon, M.D.

  • Diagnostic Radiology Physician
  • Oceanside, NY
  • NPI 1366425126
  NPD (past)

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

{
    "created_epoch": "1132358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642118400000",
    "number": "1770565178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 161527",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327161527",
            "telephone_number": "866-674-7933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9350 TURKEY LAKE RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328197319",
            "telephone_number": "407-363-2772",
            "fax_number": "407-745-2844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAND LAKE IMAGING LLLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-19",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-14",
        "status": "A",
        "authorized_official_last_name": "HOLMAN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "SR. DIRECTOR, RCM",
        "authorized_official_telephone_number": "866-674-7933"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS OF FLORIDA",
            "identifier": "V2904",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DD2395",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sand Lake Cancer Center
• Sand Lake Cancer Center, PA
• Sand Lake Cancer Center, PA
• Sand Lake Dermatology Center, P.a.
• Sand Lake Health
• Sand Lake Internal Medicine, LLC
• Sand Lake Medical Associates, P.a.
• Sand Lake Rehab & Wellness Center Inc
• Sand Lake Surgery Center, LP
• Sand Lake Surgicenter LLC

• Diagnostic Radiology Physician in Orlando, FL
• Providers in Orlando, 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 Jan 14, 2022; 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.