NPIMap

Organization Active NPI

Siegfried K Holz MD PA

Doing business as Lakeland Open MRI

  • Specialist
  • Lakeland, FL
National Provider Identifier
1922186121
Registry record updated Dec 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME40704 Issued in FL
Legal business name
SIEGFRIED K HOLZ MD PA
Doing business as
Lakeland Open MRI
Practice address
3830 S Florida Ave
Lakeland, FL 33813-1105
Phone
(863) 646-8955
Fax
(863) 648-5216
NPI assigned
Nov 2, 2006
Last updated
Dec 4, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2015

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

Authorized official

Name
Siegfried K Holz, MDNPI 1932388915
Title
President
Phone
(863) 646-8955

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME40704 FL Primary

Addresses

Primary practice location

3830 S Florida Ave
Lakeland, FL 33813-1105

Mailing address

3830 S Florida Ave
Lakeland, FL 33813-1105
Phone (863) 646-8955

Other identifiers 4

IdentifierTypeStateIssuer
2376442OtherFLAETNA
257741100MedicaidFL
47507WOtherFLMEDICARE
V2922OtherFLBC/BS

Other names 1

  • LAKELAND OPEN MRI Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Precise Diagnostic Imaging of Riverview5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

3830 S Florida Ave
Lakeland, FL 33813
Phone (863) 519-0902

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449187200000",
    "number": "1922186121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3830 S FLORIDA AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338131105",
            "telephone_number": "863-646-8955",
            "fax_number": "863-648-5216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3830 S FLORIDA AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338131105",
            "telephone_number": "863-646-8955",
            "fax_number": "863-648-5216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIEGFRIED K HOLZ MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2015-12-04",
        "status": "A",
        "authorized_official_last_name": "HOLZ",
        "authorized_official_first_name": "SIEGFRIED",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "863-646-8955",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME40704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2376442",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "257741100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "47507W",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "V2922",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LAKELAND OPEN MRI",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2015; 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.