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Organization

FLORIDA RADIOLOGY IMAGING AT LAKE MARY, LLC

Active
Other names
AdventHealth Imaging Lake Nona
Organization subpart
No

Provider details

NPI number
Authorized official
WARREN WYLIE (VP RADIOLOGY ENTERPRISE)
(407) 303-3358
Entity
Organization

Contact information

Practice address
9975 TAVISTOCK LAKES BLVD, SUITE 120, ORLANDO, FL 32827-7559
(407) 200-2865
Mailing address
9975 TAVISTOCK LAKES BLVD, SUITE 120, ORLANDO, FL 32827-7559

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary

Other

Enumeration date
02/19/2015
Last updated
02/11/2019
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