Organization
BAYCARE OUTPATIENT IMAGING LLC
Active
Other names
BOI WESLEY CHAPEL
Organization subpart
No
Provider details
NPI number
Authorized official
LYNDA GORKEN (VP PATIENT FINANCIAL SERVICES)
(727) 281-9202
Entity
Organization
Contact information
Practice address
4503 BRUCE B. DOWNS BLVLD., SUITE 104, WESLEY CHAPEL, FL 33544
(813) 586-8500
Mailing address
2995 DREW ST FL 2, CLEARWATER, FL 33759-3012
(727) 281-9065
(813) 635-2613
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101818503
—
FL
Enumeration date
12/14/2021
Last updated
05/24/2024
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