Ultra Imaging of Tampa LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

ULTRA IMAGING OF TAMPA LLC

Doing business as

Ultra Imaging of Lakeland

Practice address

2946 Lakeland Highlands Rd
Highlands Plaza
Lakeland, FL 33803-4379

Phone

(863) 583-1674

Fax

(863) 583-1678

NPI assigned

Jul 7, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Lavelle R Hardin

Title

Credentialing Coordinator

Phone

(615) 344-8203

Specialties & licenses 3

Addresses

Other names 1

• Ultra Imaging of Lakeland Doing business as

Locations

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186012800000",
    "number": "1811994551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2946 LAKELAND HIGHLANDS RD",
            "address_2": "HIGHLANDS PLAZA",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338034379",
            "telephone_number": "863-583-1674",
            "fax_number": "863-583-1678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2946 LAKELAND HIGHLANDS RD",
            "address_2": "HIGHLANDS PLAZA",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338034379",
            "telephone_number": "863-583-1674",
            "fax_number": "863-583-1678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ULTRA IMAGING OF TAMPA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-07",
        "last_updated": "2007-08-02",
        "status": "A",
        "authorized_official_last_name": "HARDIN",
        "authorized_official_first_name": "LAVELLE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "615-344-8203",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0206X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mammography",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ultra Imaging of Lakeland",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Melissa Alejandra Ulloa Hernandez
• Mark Ulloa
• Nancy M Ulm, RD
• Mary Beth Ulmer, CST
• Ultra Imaging of Tampa LLC (dba Ultra Imaging of Lakeland)
• Griselle Unda
• Anna Underwood
• Kayla Underwood
• Kristianna Lynn Underwood, BCBA
• Susan Elizabeth Underwood, OTR

• Radiology Clinic/Center in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Radiology Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.