Organization
BAYCARE OUTPATIENT IMAGING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYNDA A GORKEN (VP, PFS)
(727) 281-9065
Entity
Organization
Contact information
Practice address
2470 BLOOMINGDALE AVE STE 115, VALRICO, FL 33596-6403
(727) 281-9479
(813) 586-8516
Mailing address
2995 DREW STREET, EAST BLDG 2ND FLOOR, CLEARWATER, FL 33759
(727) 281-9390
(813) 635-2613
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101818500
—
FL
Enumeration date
10/18/2018
Last updated
07/11/2024
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