Organization
HEATHROW IMAGING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAVELLE R HARDIN (CREDENTIALING COORDINATOR)
(615) 344-8203
Entity
Organization
Contact information
Practice address
1343 S INTERNATIONAL PKWY, SUITE 1351 BLDG 3, LAKE MARY, FL 32746-1401
(407) 333-4464
(407) 333-4393
Mailing address
1343 SOUTH INTERNATIONAL PARKWAY, SUITE 1351 BLDG 3, LAKE MARY, FL 32746
(407) 333-4464
(407) 333-4393
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
—
—
261QR0200X
Radiology Clinic/Center
Primary
—
—
261QR0206X
Mammography Clinic/Center
—
—
Other
Enumeration date
06/26/2007
Last updated
07/10/2007
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