Lake Mary Imaging Center, Inc.

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

License

PENDING

Legal business name

LAKE MARY IMAGING CENTER, INC.

Practice address

917 Rinehart Rd Ste 1051
Lake Mary, FL 32746-4853

Phone

(407) 562-9170

Fax

(407) 562-9171

NPI assigned

Jul 16, 2010

Organization subpart

No

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

Authorized official

Name

Miles Edward Gilman

Title

President

Phone

(305) 665-1197

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1279238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279238400000",
    "number": "1861705071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 850001",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328850707",
            "telephone_number": "954-341-4200",
            "fax_number": "954-345-6750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "917 RINEHART RD STE 1051",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327464853",
            "telephone_number": "407-562-9170",
            "fax_number": "407-562-9171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE MARY IMAGING CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-16",
        "last_updated": "2010-07-16",
        "status": "A",
        "authorized_official_last_name": "GILMAN",
        "authorized_official_first_name": "MILES",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-665-1197"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Radiology Clinic/Center in Lake Mary, FL
• Providers in Lake Mary, 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 Jul 16, 2010; 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.