Florida Radiology Imaging at Lake Mary, LLC

NPI #1003208620 in Orlando, Florida

Provider Information

NPI Number
1003208620
Entity Type
Organization
Organization Name
Florida Radiology Imaging at Lake Mary, LLC
Primary Specialty
Radiology - Diagnostic Radiology
Enumeration Date
Feb 19, 2015
Last Updated
Feb 11, 2019

Practice Location

Address
9975 TAVISTOCK LAKES BLVD
Address 2
SUITE 120
State
Florida
ZIP Code
32827-7559
Phone
(407) 200-2865

Authorized Official

Name
WARREN WYLIE
Title
VP RADIOLOGY ENTERPRISE
Phone
(407) 303-3358

Specialties & Taxonomy Codes

Specialty
Radiology - Diagnostic RadiologyDiagnostic Radiology

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