NPIMap

Organization Active NPI

Florida Radiology Imaging at Lake Mary LLC

  • Diagnostic Radiology Physician
  • Winter Garden, FL
National Provider Identifier
1912463258
Registry record updated Feb 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
FLORIDA RADIOLOGY IMAGING AT LAKE MARY LLC
Practice address
2200 Fowler Grove Blvd Ste 60
Winter Garden, FL 34787-5597
Phone
(407) 200-0538
Fax
(407) 614-0524
NPI assigned
Feb 12, 2019
Organization subpart
Yes
Parent organization
FLORIDA RADIOLOGY IMAGING AT LAKE MARY, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 12, 2019

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

Authorized official

Name
Henderson Peter
Title
Senior Director
Phone
(407) 200-2227

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

2200 Fowler Grove Blvd Ste 60
Winter Garden, FL 34787-5597

Mailing address

900 Winderley PL Ste 2100
Maitland, FL 32751-4191
Phone (407) 200-1606

Other names 1

  • AdventHealth Imaging Winter Garden Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Adventhealth Imaging Center Innovation12 organizations share this tax ID, including this one
Part of
Adventhealth Imaging Center Innovation

Other organizations with this tax ID 11

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

Locations

2200 Fowler Grove Blvd
Winter Garden, FL 34787
Phone (407) 614-0500

NPI Registry JSON

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

{
    "created_epoch": "1549929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549929600000",
    "number": "1912463258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 WINDERLEY PL STE 2100",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327514191",
            "telephone_number": "407-200-1606",
            "fax_number": "407-303-0893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 FOWLER GROVE BLVD STE 60",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347875597",
            "telephone_number": "407-200-0538",
            "fax_number": "407-614-0524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA RADIOLOGY IMAGING AT LAKE MARY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FLORIDA RADIOLOGY IMAGING AT LAKE MARY, LLC",
        "enumeration_date": "2019-02-12",
        "last_updated": "2019-02-12",
        "status": "A",
        "authorized_official_last_name": "PETER",
        "authorized_official_first_name": "HENDERSON",
        "authorized_official_title_or_position": "SENIOR DIRECTOR",
        "authorized_official_telephone_number": "407-200-2227"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AdventHealth Imaging Winter Garden",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winter Garden, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2019; 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.