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Organization
LAKE MARY IMAGING CENTER, INC.
Active
Organization
LAKE MARY IMAGING CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MILES EDWARD GILMAN (PRESIDENT)
(305) 665-1197
Entity
Organization
Contact information
Practice address
917 RINEHART RD STE 1051, LAKE MARY, FL 32746-4853
(407) 562-9170
(407) 562-9171
Mailing address
PO BOX 850001, ORLANDO, FL 32885-0707
(954) 341-4200
(954) 345-6750
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
PENDING
—
Other
Enumeration date
07/16/2010
Last updated
07/16/2010
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