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LAKE MEDICAL IMAGING AND BREAST CENTER AT THE VILLAGES LLC NPI 1912570045


NPI Information

NPI: 1912570045
Provider Name: LAKE MEDICAL IMAGING AND BREAST CENTER AT THE VILLAGES LLC
Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

Address:
910 OLD CAMP RD STE 120
THE VILLAGES, FL
ZIP 32162
Phone: (352) 787-5858
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LAKE MEDICAL IMAGING AND BREAST CENTER AT THE VILLAGES LLC is a diagnostic radiology radiology in The Villages, FL. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. LAKE MEDICAL IMAGING AND BREAST CENTER AT THE VILLAGES LLC NPI is 1912570045. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

910 OLD CAMP RD STE 120
THE VILLAGES, FL
ZIP 32162-605
Phone: (352) 787-5858
Fax: (352) 787-4655

The provider's authorized official is Joshua Lee Floyd .
The authorized official title is Director, Risk Management and has the following contact phone number (365) 352-2583.

The enumeration date for this NPI number is 7/16/2021 and was last updated on 7/21/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12085R0202XRadiologyDiagnostic RadiologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1101183204MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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