Clinical Pet of Lake City

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

CLINICAL PET OF LAKE CITY

Practice address

484 SW Commerce Dr
Suite 145
Lake City, FL 32025-1507

Phone

(386) 754-3092

Fax

(386) 754-6176

NPI assigned

Aug 30, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Garesh D Arora

Title

President

Phone

(352) 494-6142

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Waseemullah Khan, MD

  • Medical Oncology Physician
  • Lake City, FL
  • NPI 1073557864
  NPD (past)

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212969600000",
    "number": "1972596450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 773029",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344773029",
            "telephone_number": "352-795-0847",
            "fax_number": "352-795-7843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "484 SW COMMERCE DR",
            "address_2": "SUITE 145",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320251507",
            "telephone_number": "386-754-3092",
            "fax_number": "386-754-6176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICAL PET OF LAKE CITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-30",
        "last_updated": "2008-06-09",
        "status": "A",
        "authorized_official_last_name": "ARORA",
        "authorized_official_first_name": "GARESH",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-494-6142",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "V2683",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melanie W. Clark, DPH.
• Jayme Leigh Clayton, MOT
• Taylor Brooke Clayton
• Clearsky Rehabilitation Hospital of Lake City LLC
• Brittni Cleland, R-DMT
• Club Community Care LLC
• Jourdan Ashley Clum, ARNP
• CMS Professional Transport, Inc.
• Coast Dental P.a.
• Coast Multi-Specialty Medical Group P.a

• Radiology Clinic/Center in Lake City, FL
• Providers in Lake City, 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 Jun 9, 2008; 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.