NPIMap

Organization Active NPI

Adventhealth Imaging Center Innovation

  • Clinic/Center
  • Orlando, FL
National Provider Identifier
1841936879
Registry record updated May 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
ADVENTHEALTH IMAGING CENTER INNOVATION
Practice address
265 E Rollins St
Ste 1000
Orlando, FL 32084
Phone
(407) 303-1414
NPI assigned
May 11, 2022
Last updated
May 11, 2022By 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 May 11, 2022

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

Authorized official

Name
Michael Mazeres
Title
VP/Cfo
Phone
(407) 200-2227

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

265 E Rollins St
Ste 1000
Orlando, FL 32084

Mailing address

265 E Rollins St
Ste 1000
Orlando, FL 32084
Phone (407) 303-1414

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
Tax ID family
Adventhealth Imaging12 organizations share this tax ID, including this one
Part of
Adventhealth Imaging

Other organizations with this tax ID 11

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

Locations

25 S Terry Ave
Ste 220
Orlando, FL 32805
Phone (407) 641-2446

Practitioners & affiliated clinicians

Practitioners 27

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 27

NPI Registry JSON

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

{
    "created_epoch": "1652227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652227200000",
    "number": "1841936879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 E ROLLINS ST",
            "address_2": "STE 1000",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32084",
            "telephone_number": "407-303-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 E ROLLINS ST",
            "address_2": "STE 1000",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32084",
            "telephone_number": "407-303-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVENTHEALTH IMAGING CENTER INNOVATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FLORIDA RADIOLOGY IMAGING AT LAKE MARY, LLC",
        "enumeration_date": "2022-05-11",
        "last_updated": "2022-05-11",
        "certification_date": "2022-04-28",
        "status": "A",
        "authorized_official_last_name": "MAZERES",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "VP/CFO",
        "authorized_official_telephone_number": "407-200-2227"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 May 11, 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.