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Individual

MARY RAYMOND

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1305 LAKELAND HILLS BLVD, LAKELAND, FL 33805-4542
(863) 688-2334
Mailing address
2115 CRYSTAL GROVE DR, LAKELAND, FL 33801-6875
(863) 688-2334

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
77956
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NONE
NONE
Enumeration date
03/19/2019
Last updated
08/28/2025
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