Organization
FLORIDA RADIOLOGY IMAGING AT LAKE MARY LLC
Active
Parent organization
FLORIDA RADIOLOGY IMAGING AT LAKE MARY LLC
Other names
Florida Radiology Imaging at Universal Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
FLORIDA RADIOLOGY IMAGING AT LAKE MARY LLC
Authorized official
BRIAN REEVES D.O. (MEDICAL DIRECTOR)
(407) 834-8722
Entity
Organization
Contact information
Practice address
6000 TURKEY LAKE RD, SUITE 107, ORLANDO, FL 32819-4200
(407) 834-8722
(407) 834-5325
Mailing address
PO BOX 150130, ALTAMONTE SPRINGS, FL 32715-0130
(407) 767-5028
(407) 767-8443
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
V3162
BCBS GROUP NUMBER
FL
Enumeration date
11/29/2006
Last updated
02/25/2008
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