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Organization
ADVENTHEALTH IMAGING CENTER PORT ORANGE
Active
Organization
ADVENTHEALTH IMAGING CENTER PORT ORANGE
Active
Parent organization
FLORIDA RADIOLOGY IMAGING AT LAKE MARY, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
FLORIDA RADIOLOGY IMAGING AT LAKE MARY, LLC
Authorized official
MICHAEL MAZERES (VP/CFO)
(407) 200-2227
Entity
Organization
Contact information
Practice address
5821 S. WILLIAMSON BLVD, SUITE 101, PORT ORANGE, FL 32128
(386) 231-2951
(386) 231-2952
Mailing address
5821 S. WILLIAMSON BLVD, SUITE 101, PORT ORANGE, FL 32128
(386) 231-2951
(386) 231-2952
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Enumeration date
07/28/2022
Last updated
07/28/2022
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