Individual
MR. BILLY BLAKE WHITE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RA (RADIOLOGIST ASS)
Contact information
Practice address
1305 LAKELAND HILLS BLVD, LAKELAND, FL 33805-4542
(863) 688-2334
Mailing address
412 BAYOU RD, WINTER HAVEN, FL 33884-2507
(863) 651-7255
Taxonomy
Speciality
Code
Description
License number
State
243U00000X
Radiology Practitioner Assistant
Primary
RA63
FL
Other
Enumeration date
03/06/2024
Last updated
03/06/2024
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